• 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.35 no.2
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• pp.35-38
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• 2019

Oncocytic lipoadenoma is a rare salivary gland tumor composed of adipose tissue and oncocytic epithelial cells in varied proportions. We report a case of an oncocytic lipoadenoma of the submandibular gland, which presented as a submandibular gland mass. The patient was a 65-year-old woman with a right submandibular mass measuring 2 × 2 × 1.6 cm. As a sonographic evaluation and computed tomograph scan gave us the impression of benign submandibular gland tumor such as pleomorphic adenoma, we resected the right side submandibular gland. Grossly, the tumor was well circumscribed with yellow to brown cut surface. Microscopically, the tumor was surrounded by a thin, fibrous capsule and composed of oncocytic epithelial cells admixed with mature adipose tissue. Final diagnosis was an oncocytic lipoadenoma. We discussed here radiologic and pathologic finding of this rare salivary gland tumor.

• The Korean Journal of Cytopathology
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• v.7 no.1
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• pp.64-68
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• 1996

The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed blanching tubular structures composed of two type of cells; darker cells haying eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring $2{\times}1.5{\times}2cm$. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the taller on the immunohistochemical stain.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.65-67
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• 2018

Pleomorphic adenoma (PA) is a benign tumor which usually originates from major and minor salivary glands. This tumor arising outside submandibular gland (SMG) is extremely rare. To author's knowledge, only four cases have been reported so far in English literature. Its pathogenesis is still unclear, but it can be explained by embryologic theory of major salivary gland. A 68-year-old man with an incidental mass on left upper lateral neck visited to our clinic. The radiologic findings showed well-margined round mass outside left SMG. The excisional biopsy revealed a pleomorphic adenoma. We report the rare and unique case with a brief literature review.

• The Korean Journal of Physiology and Pharmacology
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• v.7 no.2
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• pp.97-101
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• 2003

The salivary glands produce 1.5L of fluid per day. As in other exocrine organs, the general mechanism in the salivary glands is that water movement occurs secondary to osmotic driving forces created by active salt transport. Therefore, high water permeability in the salivary glands is expected to have a variety of aquaporin (AQP), a water channel. Although some AQPs have been known to be present in the salivary glands, roles of parasympathetic nerve in AQP expression have not yet been examined. This study was designed to examine the changes of AQPs and extracellular signal-regulated kinase (ERK) in the submandibular glands after parasympathetic denervation. Right chorda-lingual nerve was cut, and each right (experiment) and left (control) submandibular gland was excised at 1, 3, 7, 14, 30 days after denervation. The denervated right submandibular glands were resulted in weight loss and morphologic changes, including cell loss and atrophy, as the time elapsed after parasympathetic denervation increased, whereas there were no histologic alteration in control side. AQP5 which is known to reside in apical membrane and secretory caraliculi of the submandibular acini were gradually underexpressed according, as the time after denervation increased. Expression of AQP4 in submandibular ductal epithelium was down-regulated after denervation. Besides, AQP3 and 8, which is known to be present in basolateral membrane of the glandular acini, were gradually underexpressed after denervation, similar to the pattern of other types. Expression of ERK, a mitogen-activated protein kinase, was downregulated after parasympathetic denervation in the submandibular gland. These results suggest that parasympathetic nervous system regulates the expression of AQPs in salivary glands, and is in part mediated by ERK pathway.

• Clinical and Experimental Pediatrics
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• v.55 no.6
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• pp.215-218
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• 2012

Mucoceles are common benign cystic lesions of the oral cavity that develop following extravasation or retention of mucous material from the major or minor salivary glands. Mucoceles are usually located in the lower lip (60 to 70% of cases), and the floor of the mouth is only involved in 6 to 15% of cases. Submandibular gland mucocele is extremely rare but should be considered in the differential diagnosis of swelling at the submandibular triangle in young children. We present the rare case of a 16-month-old child who was diagnosed with bilateral submandibular gland mucocele, presenting as serial swellings in both submandibular regions. We removed the cystic mass with the submandibular and sublingual glands to prevent recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.1
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• pp.61-69
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• 1997

The submandibular gland is one of the major salivary glands, salivary diseases frequently occuring site due to its anatomical weakness. This retrospective study evaluated data pertaining to history, sex, operation method, age distribution, diagnosis through the chart, operation record, radiographs, histologic finding of 51 patients operated on for the submandibular gland excision from 1986 to 1995 in our hospital so that we improve on the understand of the salivary gland diseases. The results were as follows ; 1. The chief complaints was mass, swelling mainly. 2. The ratio of affected site was 47.1 : 51 in left : right respectly, both sites was 1 case especially. 3. The ratio of men to women was 56.9 : 43.1 4. The operation performed all through the extraoral approach. 5. The sialolith presented at 24 cases. 6. The most patients had a two weeks duration period. 7. The age distribution was the third decade(29.4%), the second decade(27.5%) in order. 8. The symptoms accompanied the chief complaints was pain(37.3%), mass(17.6%), swelling(13.7%), trismus(13.7%) in order. 9. The diagnosis was sialadenitis with stone(S.W.S.) (45.1%), sialadenitis without stone(S.W.O.S.) (17.6%), pleomorphic adenoma(P.A.) (15.7%), abscess(Abs) (5.9%), tuberculosis(Tbc) (5.9%) in drder.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.2
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• pp.163-166
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• 1994

Pleomorphic adenoma(benign mixed tumor) is the most common tumor of the major salivary glands, constituting approximately 70 per cent of benign tumors of these glands. The term mixed tumor was introduced in the nineteenth century to stress the dual origin of this neoplasm from epithelial and mesenchymal elements, and the designation pleomorphic adenoma is preferred because it emphasizes both the epithelial origin and the variety of histological patterns found in this common salivary gland lesion. Rauch, in a review of 4245 pleomorphic adenomas, found 92.5 per cent in the major salivary glands and 6.5 per cent in the minor salivary glands, 8 per cent arose in the submandibular glands, and in another large series of over 6,000 cases, approximately 4 per cent arose in the hard and soft palates with equal frequency in each. The prognosis of pleomorphic adenoma depends more upon the choice and adequacy of treatment than upon histological appearances. The accepted treatment for this tumor is excision. With adequate surgery recurrence rates of less than 1 per cent can be obtained. In this hospital, I experienced two patients who were identified PMA which occurred in the hard palate and submandibular gland. The lesions were successfully treated by surgery.

• Journal of Oral Medicine and Pain
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• v.23 no.4
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• pp.309-326
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• 1998

In general, the major causative factor of halitosis is thought to be a sulfated compounds. Clusterin, a sulfated glycoprotein-2(SGP-2), is frequently found in diabetic conditions and cold stress conditions. The same result is werum glucose level to diabeteic and cold stress conditions that founded Clusterin. Therefore, this study was performed to examine Clusterin in the slivary glands under stress conditions before insulin injection I.M. Fourty rats were diveded into 3 groups ; 1) 10 rats of gorup I were selected as a control 2) 15 rats beloning to group II were bathed in cold water for 30 seconds twice a day 3) 15 rats in group III received cold stress and injected I.M. with insulin. The rats were sacrifeced at day 0, 3, 5, 7 and 10 of the experiment and the submandibular glands and parotid galnds were removed. RNAs were purified from the salivary of the salivary glands were subjected to Hematoxillin-Eosin stainings and examined under the light microscope. The obtained results were as follows : 1. With immunohistochemistric method, in normal control goup, Clusterin was moderately stained in the intercalated ductal cell of the submandibualr glands, mild stained in the striated ductal cell of the submandibular glands, heavily stained on the cytoplasm of the intercalated ductal cell in the mucous submandibular glands nad slightrly stained in the intercalated ductal cell of the paroted gland, expressed negativity in the acina cell. 2. With immunohistochemistric method, Clusterin slightly increased in the acina cell of the submandibular glands under stress condition at 3 days after experement, moderately stained at 5 days after experiment so revealed positive response. And hearily in the intercalated ductal cell and mildly lin the acina celluar eytoplasm of the parotid glands under stress condition at 3 days experiment. 3. With immunohistochemistric method, no remarkable differences are found between the normal control group and stress conditioned group that insulin administration was performed before. 4. In the stressor-giving group, Clusterin mRNA was porminently expressed in submandibular gland after 5 days after experiment, in parotid gland after 3 days after experiment, performed in immunoelectrophoresis method. 5. In the insulin-injected nad stressor-giving group, Clusterin mRNA was not observed in all experimental submandibular and parotid gland, performed in immunoelectrophoresis method.

• Journal of Oral Medicine and Pain
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• v.39 no.3
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• pp.83-89
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• 2014

Purpose: Chronic nicotine administration induce various effects in whole organs of the body; however, little is known about salivary gland. In the present study, we pursued the links between systemic nicotine and the histomorphological changes of the salivary gland in mice. Methods: Twenty-five C57BL6 mice were allocated into two groups. The control group (n=9) received distilled water only for 8 weeks by gavage. The experimental nicotine group (n=16) was administered nicotine $5{\mu}g/g$ with distilled water. Animals were sacrificed at 8 weeks; then, submandibular glands were excised and processed for histologic evaluation. Volumetric changes in acinar cells were evaluated by H&E staining. The expression of calponin-positive myoepithelial cells and Ki-67-positive proliferating acinar cells were evaluated by immunohistochemistry. Results: The nicotine group showed significantly decreased number of calponin-positive myoepithelial cell process compared with the control group. There were no significant differences in average volume of acinar cell and the number of Ki-67-positive acinar cells between both groups. Conclusions: These findings suggested that chronic nicotine administration may cause decreased function of myoepithelial cells in submandibular glands of mice, and these can partly explain xerostomic conditions in chronic smokers.