Sublingual gland removal
Sublingual Gland Removal is usually performed for recurrent floor of mouth swelling, sometimes called a ranula.
Some advocate procedures such as marsupialisation of the gland, to avoid gland removal. Most of these send patients down a path of multiple visits and repeat procedures. We usually advocate sublingual gland removal instead which in our hands is a straight forwards procedure.
Under a short general anaesthetic an incision or cut is made on the undersurface of the side of the tongue. The gland is carefully and gently dissected or teased from the neighbouring structures in the floor of mouth, namely the lingual nerve and the submandibular duct. The gland is then removed and sent to the pathologist for assessment. Sometimes a few dissolving sutures are placed in the floor of mouth – these do not need to be subsequently removed.
Patients stay in overnight for observation and are usually well enough to be discharged the next morning.
At the time of surgery, long-acting local anaesthetic will be placed and strong painkillers given. Usually simple analgesics are all that are required on discharge, along with mouthwashes. It is important to maintain good oral hygiene and advice will be given by your surgeon.
The mouth tends to heal well but infections are possible. Try to maintain good oral hygiene on the run up to your operation. Antibiotics will be given during your operation a and a short course afterwards. Specific advice will be given if any problems arise.
Sometimes the floor of mouth can become quite swollen after surgery and you will be observed overnight afterwards. Usually the swelling is mild and resolves in 5-7 days. Patients are usually able to commence a soft diet straight away.
Numbness to the tongue
The lingual nerve lies directly underneath the sublingual gland in the floor of mouth and can be injured during gland removal. It is not uncommon to have some mild temporary numbness or altered sensation after surgery because the nerve has to be carefully handled. This usually resolves within a few weeks. Rarely the nerve can be permanent injured.
Damage to the submandibular duct
The duct or tube which carries saliva from the submandibular salivary gland (under the jaw) passes forwards in the floor of mouth under the sublingual gland to empty just under the tongue. The duct can be damaged during surgery. If that is apparent at the time then the duct can be repositioned. If the duct is damaged, this would cause the submandibular gland to swell because it would be draining its saliva.