Trans-Oral Versus Trans-Cervical Submandibular Gland Removal in Benign Submandibular Gland Swelling Patients.

Background: The main advantages of trans-oral (TOA) removal of submandibular gland (SM) are to eliminate the potentiality of remnant duct disease since the entire duct and papillae are removed and avoid cervical scar. The aim of this work was to assess the feasibility and outcome of TOA for removal of the submandibular gland (SMG) in comparison to the standard transcervical (TCA) approach. Methods: This study was applied on 18 patients with benign SMG swelling indicated for gland excision.9 patients were operated via the standard TCA and 9 patients were operated via the recent TOA. Then the patients were followed up and assessed for postoperative pain, edema, nerve deficits, scar and complication. Results: All patients complained of intermittent pain and swelling in the submandibular area. TOA take longer operative duration than TCA.TOA led to more severe early postoperative symptoms than the TCA, including postoperative pain in all patients, salivary pooling in six cases (66.7%), temporary tongue numbness and hypoesthesia that was reported in all cases, tongue deviation on protrusion was documented in one case (11.1%), and mouth floor infection was detected in 2 cases. All these symptoms resolved after one week and did not leave permanent sequela. Non-disfiguring visible neck scar was seen in all the TCA cases without reported complication of the scar. Conclusion: Even though, the TOA for excision of the SMG is not easy and takes a longer duration and most patients temporarily complained of neurologic problems of the lingual nerve, but these were completely resolved within 2 months after surgery. [ABSTRACT FROM AUTHOR]