Before you agree to have your submandibular gland operation it is sensible to know all you can about it. The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your choices of treatment for stones in submandibular gland with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.
What is the problem?
Your submandibular gland is swollen or contains a stone (calculus). You may have pain and swelling when eating. The pain and swelling disappear between meals only to return when you next eat.
Submandibular gland
Submandibular gland 2
What is the submandibular gland?
The word ‘submandibular’ means under the jawbone (mandible). The submandibular duct is a tube, which runs from under the front of the tongue to the submandibular gland. There is a submandibular gland under the side of the jawbone on each side. They are about the size a plum.
The gland is one of the glands that make spit (saliva). These are called the salivary glands. Saliva is important in the breaking down (digestion) of the food that we eat. It makes food moist, lubricating it as it passes from the mouth to the gullet. Saliva is produced in the gland; it trickles through the submandibular duct into the mouth and mixes with food when we are chewing.
What has gone wrong?
The most common cause of the swelling is one or more stones in the gland. The stone(s) stop saliva from flowing into your mouth when you eat and chew. When eating and chewing, the gland works hard and makes a lot of saliva. The blockage makes the gland swell and become painful because the saliva cannot pass from it. After a meal, the saliva has time to seep past the stone. The swelling and pain may then settle down again.
Sometimes the gland becomes swollen due to repeated infections, often caused by a blockage with stones.
Sometimes the cause of a swelling in the gland is a growth (tumour).
The aims
The aim of the operation is to completely remove the submandibular gland along with any stones that may be there.
You will have a general anaesthetic and be completely asleep while this is done.
The benefits
You will lose the swelling below the side of the jaw. The gland will be examined in the laboratory to check whether the swelling was due to a stone, an infection or a tumour. This will tell us if any further treatment is needed.
Having one submandibular gland removed will not give you a dry mouth due to a lack of saliva.
Are there any alternatives?
There are no drugs or x-ray treatments that will safely get rid of a swelling in the submandibular gland.
If the swelling is due to a stone in the submandibular duct, the swelling may be associated with mealtimes. The swelling probably reduces between meals. If the stone blocking the duct is positioned close to the opening of the duct in the mouth, it may be possible to remove the stone only and leave the gland alone. Ask your surgeon for more details if you think this may apply to you. This operation is called submandibular duct stone excision and is covered in more detail in a separate information leaflet within this series.
What if you do nothing?
If you do nothing the submandibular gland will remain swollen. It may get larger and cause more pain.
There may be some uncertainty about the cause of the swelling. X-rays, needle tests and blood tests may not give a clear answer. If you do nothing, and there is a question mark about the cause of the swelling, you could be missing out on important treatment.
Who should have it done?
A person with a submandibular gland swelling that cannot be treated by removal of the stone should have the gland removed.
Who should not have it done?
People who have other medical conditions that would make it unsafe for them to have a general anaesthetic should not have one.
Author: Mr Robert Ruckley MB. ChB. F.R.C.S. Consultant ENT surgeon.
© Dumas Ltd 2006
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