• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.464-472
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• 1994

Surgical removal of the submandibular gland via intraoral approach was performed. The surgical procedure to be used for removal of submandibular gland had been performed via extraoral approach for many centuries. Disadvantages of extraoral technique are the esthetic distress due to an external scar, residual inflammation in Wharton's duct, and neurological complications. Indications of intraoral approach are unlimited in surgical cases of submandibular gland. Advantages of intraoral approach are esthetic satisfaction due to no remaining scars, preservation of adjacent anatomical structures and preservation of lower facial contour. This paper describes the surgical technique of the submandibular gland excision through an intraoral approach and variable incision lines tried. In 7 cases, excellent results were obtained after removal of the submandibular gland through an intraoral approach.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.196-200
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• 2000

Objectives: Submandibular gland tumors is rare. The aim of this study is to get a clinical feature of submandibular gland tumors and to apply a treatment of submandibular gland tumors of future patients. Methods: We analyzed retrospectively the 18 patients with submandibular gland tumors who were treated surgically at Presbyterian Medical Center(PMC), during the period of 8 years from 1992 to 1999. Analysis was performed regarding the incidence, classification, surgical treatment, surgical complication, recurrence and prognosis. Result : 1) Male to female sex ratio was 1:1.25, the most prevalent age group was the 5th decade. 2) Benign tumors were 12 cases(66.7%) and malignant tumors were 6 cases(33.3%). 3) Histopathologically, the most common benign submandibular gland tumor was pleomorphic adenoma, and the most malignant submandibular gland tumor was adenoid cystic carcinoma. 4) In pleomorphic adenoma, excision of submandibular gland was performed in all case(8case). In malignant tumors, excision and supraomohyoid node dissection was performed in 3cases, and modified-radical neck dissection(RND) was performed in 2cases, and than standard RND was performed in 1case. 5) In the malignant tumor, we choose a radiation therapy as adjuvant therapy. 6) In a surgical complication of submandibular gland tumor, we had a facial nerve injury(1case). 7) Recurrence rate of submandibular gland tumor was 22.2%, and than all case were malignant tumor. Overall 5-year survival rate of submandibular gland cancer was 50%. Conclusion: In above results, postoperative recurrence rate is low in benign, but high in malignant tumor of submandibular gland. Surgical procedure should not be aggressive in benign tumor, but should be aggressive in malignant tumor of submandibular gland and an adjuvant radiation therapy should be considered.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.75-78
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• 2010

Purpose: Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. The purpose of this study is to examine the clinical characteristics of rare bilateral plunging ranula arising from accessory submandibular gland in order to provide our experience for its correct diagnosis and treatment. Methods: A 13-year-old girl manifests as a slow growing painless, non-mobile swelling in the anterior neck. She underwent surgery via a cervical approach. A pseudocyst was extirpated and adjacent accessory gland tissue and related lymph node were removed. Results: The histologic appearance is characteristically of a cyst, devoiding of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophage stuffed with mucin. Pathologic findings represented a form of myxomatous degeneration and lined by condensed connective tissue and granulation tissue. The nature of the accessory gland tissue was same as subligual gland. Although total submandibular or sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods. Conclusion: Usually, unilateral plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. But our case developed because of bilateral congenital accessory submandibular gland. This is thought to be a result from a congenital failure of canalization of the terminal end of the duct. Finally, the correct diagnosis is essential for the most effective treatment, which is excision of the ranula and related accessory salivary gland. We performed excision of accessory submandibular gland and plunging ranula and had a good result without recurrence.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.111-115
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• 2010

Purpose: A plunging ranula is relatively uncommon and represents a mucus escape reaction occurring from a disruption of the sublingual salivary gland. It is a common condition found in young adults, even though the reported age range is 2 - 61 years. We report our experience of a complete excision of a plunging ranula via the intraoral and submandibular approach. Methods: A 23-year-old man had a large protruding mass in the right submandibular area. Initially, the protruding mass appeared bilaterally but the left side disappeared spontaneously. The MRI findings revealed a homogenous fluid attenuation mass in the submandibular space, suggesting a ranula. The sublingual gland was extirpated through the intraoral approach and the ranula excised totally via the submandibular approach. Results: The patient had an uneventful postoperative course without infection, paralysis and tongue sensory changes, etc. The pathology findings were characteristic of a pseudocyst without a lining epithelium or endothelium but with a vascular fibro-conective tissue wall filled with mucinous fluid. No recurrence was observed on the submandibular area during the 8 month follow-up period. Conclusion: The combined intraoral approach and submandibular approach is an effective and highly recommended method for sublingual gland extirpation and complete excision of a plunging ranula.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.545-550
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• 2004

Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.6
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• pp.548-552
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• 2010

The submandibular gland is the second largest major salivary gland, which secretes 40% of the total daily saliva. Owing to its anatomic characteristics as well as the high viscosity and basicity of the saliva, sialolithiasis is found most commonly in the submandibular gland. Sialolithiasis that cannot be treated by conservative treatment is conventionally removed by an excision of the submandibular gland. Generally, an excision of the submandibular gland is performed via an extra-oral approach but the disadvantages of this treatment include a risk of injuring the facial nerve and scar formation. Case reports have revealed an even less invasive intraoral surgical technique for the removal of sialolith that does not affect the submandibular gland function. The functional recovery of the gland, complications and recurrence rates after surgery with this conservative intraoral procedure were all successful. We report 5 patients from the department of Oral and Maxillofacial Surgery at Dental Hospital, Yonsei University, who had undergone a resection of the sialolith though the intraoral approach with successful results.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.41-44
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• 2023

Follicular dendritic cell sarcoma (FDCS) is rare lymphoid sarcoma occurs anywhere in body, mostly in lymph nodes. Sixty-two-year-old man presented left submandibular gland region mass for 5 months. Mass excision with submandibular gland resection was performed. Histopathology showed proliferation of spindle and ovoid cells with storiform arrangement which were positive for CD21, CD23, Vimentin, Ki-67, suggested FDCS in submandibular gland region lymph node. Tumor size was 3cm with no involvement of resection margin, nor cellular atypia and necrosis, so regular follow up was performed. After 4 years, new enhancing mass in left submandibular area was found. Wide excision of mass with neck dissection on left level I-III was performed. Histopathology confirmed recurrence of FDCS. The patient underwent radiation therapy from left mandible to hyoid area. After 2 years, new nodule was found in left lung upper lobe, and wedge resection confirmed metastasis of FDCS. The patient is on adjuvant chemotherapy.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.171-177
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• 1994

We reviewed retrospectively 152 patients' records with salivary gland tumors confirmed histologically at Hanyang University Hospital from Jan. 1984 to Dec. 1993. The results obtained were as follows: 1) Sites of tumors were parotid gland in 102 cases(67%), submandibular gland in 29 cases(19%) and minor salivary glands in 21 cases (14%). 2) 113 cases(74%) were benign. and 39 cases(26%) were malignant. 3) The incidence of benign and malignant tumors were 81% & 19%, 69% & 31% and 48% & 52% in the parotid gland, the submandibular gland and the minor salivary glands respectively. 4) The most frequent histologic types of benign and malignant tumors were pleomorphic adenoma (64%) and mucoepidermoid carcinoma (11%) respectively. 5) The surgical procedures include superficial parotidectomy. total parotidectomy. extended total parotidectomy & neck dissection in the parotid gland. wide excision & neck dissection in the submandibular gland and wide excision, partial maxillectomy & neck dissection in the minor salivary glands. 6) The postoperative recurrence rate were 4.4% in benign tumors and 27% in malignant tumors.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.46-48
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• 2015

Cystadenocarcinoma of salivary gland is an rare, slow-growing, low-grade malignant neoplasm characterized by cysts and papillary endocystic projections. Major locations of this tumor are parotid glands, and minor salivary glands, while occurrence in submandibular gland is extremely rare. Only few cases have been reported in the literatures. Cystadenicarcinoma behaves in an indolent manner and recurrence is rarely occured, surgical complete excision is considered treatment of choice. We experienced a case of cystadenocarcinoma arising from submandibular gland, so we report this case with a review of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.2
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• pp.93-98
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• 1993

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50% of all cases of tumors of both major and minor salivary gland origin and approximately 90% of all benign salivary gland tumors. Of the major salivary glands, the parotid gland is the most common site of the pleomorphic adenoma. It may occur, however, in any of the major gland or in the widely distributed intraoral accessory salivary glands. The palatal glands are frequently the site of origin of tumors, and other parts of origins are as follows: upper and lower lip, buccal mucosa, tongue and occasionally other sites. The majority of the lesions are found in patients in the fourth to sixth decades, but they are also relatively common in young adults and have been known to occur in children. It is somewhat more frequent in women than men. The term "mixed tumor" has masquaeraded under a great variety of names throughout the years (e.g., enclavoma, branchioma, endothelioma, enchondroma), but the term "pleomorphic adenoma" suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The accepted treatment for this tumor is surgical excision. The intraoral lesions can be treated somewhat more conservatively by extracapsular excision. In general, Lesions of the hard palate should be excised with the overlying mucosa, while those in lining mucosa, such as the lips, soft palate and buccal mucosa often can be treated successfully by enucleation or extracapsular excision. In our hospital, we experienced two patients who were identified pleomorphic adenoma which occurred at buccal mucosa, submandibular gland. The lesions were successfully treated by surgical excision.