What is Submandibular Gland Removal

Submandibular gland removal is a procedure to remove one of the two glands that are located under your lower jaw (submandibular glands).

These glands release saliva into your mouth, which keeps your mouth moist, helps you digest foods, and helps to prevent tooth decay. Removing a submandibular gland will not cause you to stop producing saliva.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.
• Any symptoms of infection you have, such as a fever or cough.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reactions to medicines or dyes.
• Damage to facial nerves or other structures or organs.
• Losing feeling in your tongue.
• Problems moving your tongue.
• A collection of normal body fluid that gathers after the drain is removed (seroma), which can lead to infection.
• The formation of a cavity under the skin that contains saliva (sialocele), which can cause pain and other problems.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicine

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.

General instructions

• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• Ask your health care provider how your surgical site will be marked or identified.
• To reduce your risk of infection:
  • You may be given antibiotic medicine.
  • You may be asked to shower with a germ-killing soap.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• An incision will be made in your neck.
• The muscle that helps your lower lip to move will be cut open.
• The gland or glands will be removed. If you have a cancerous tumor, some of the surrounding bone, tissue, or nerves may also be removed.
• A small tube (drain) may be placed at the surgery site to drain blood and fluid that may gather where the gland was removed.
• Any tissue that was cut to remove the tumor will be closed with stitches (sutures).
• The incision on your neck will be closed with sutures, skin glue, or adhesive strips.
• A bandage (dressing) may be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• It may take several weeks to recover full function after the procedure.
• If a drain was placed at the surgery site, it will be taken out in a few days.
• You may be given antibiotic medicine.
• Do not drive for 24 hours if you were given a sedative.

Summary

• The two submandibular glands are located under your lower jaw. They release saliva into your mouth, which keeps your mouth moist, helps you digest foods, and helps to prevent tooth decay.
• Removing a submandibular gland will not cause you to stop producing saliva.
• Generally, this is a safe procedure. However, problems may occur.
• For the procedure, you will be given a medicine to help you relax (sedative), a medicine to numb the area (local anesthetic), a medicine to make you fall asleep (general anesthetic), or more than one of these medicines.

Care After Submandibular Gland Removal

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Fatigue.
• Poor appetite. Your appetite will most likely improve after the anesthetic you were given wears off.
• Numbness or pain in the incision area.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips unless your health care provider tells you to do that.
  • Keep the incision dry for the first week following surgery.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Do not drive or operate heavy machinery while taking prescription pain medicine. Ask your health care provider when it is safe to drive.
• Avoid activities that require a lot of effort (are strenuous) as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that your health care provider tells you, until he or she says that it is safe.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
• Drink enough fluid to keep your urine clear or pale yellow.

Medicines

• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if your condition improves.

General instructions

• Sleep with your head raised higher than your chest for the first 4 or 5 days after surgery. Prop up your head on two or three pillows or sleep in a recliner.
• Follow instructions from your health care provider about drain care. Make sure you empty the drain at least two times a day.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You cannot eat or drink without vomiting.
• You have pain that does not go away even after you take your prescription pain medicine.
• You have redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.

Get help right away if:

• You have trouble breathing.
• You have sudden chest pain.
• You are suddenly short of breath.
• You cough up blood.

Summary

• Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer.
• Drink enough fluid to keep your urine clear or pale yellow.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Check your incision area every day for signs of infection, such as redness, swelling, pain, fluid, blood, warmth, pus, or a bad smell.
• Keep all follow-up visits as told by your health care provider. This is important.