Bechara Y. Ghorayeb, MD, PA
Otolaryngology-Head & Neck Surgery                                                        Phone: 713 464 2614
1140 Business Center Drive, Suite 560
Houston, TX 77043                      www.ghorayeb.com
Submandibular Gland Resection
Informed Consent
What is the submandibular gland?
The submandibular gland (also called submaxillary gland) is a salivary gland about the size of a plum that lies immediately below the lower jaw. The most common reason for removing a submandibular gland is chronic infection that occurs if the ducts that drain saliva become blocked with  a stone.  Other indications for surgery include benign tumors, such as pleomorphic adenomas.  Whereas 80% of parotid gland tumors are benign, in the submandibular gland, 66% of tumors are malignant.
How is surgery done?
The submandibular gland is resected under a general anesthetia.  A cut around two inches long is made in the upper part of the neck just below the lower jaw. The gland is dissected away from the surrounding muscles, vessels and nerves. 
Will I have a scar?
Yes.  All cuts made through the skin leave a scar but the majority of these fade with time and are difficult to see when they are fully healed.   It may take several months for your scar to fade but eventually it should blend into the natural folds and contours of your face. 
What are the possible problems?
Bleeding from the wound is unlikely to be a problem. 
Infection is uncommon, but you will receive a short course of antibiotics.
Very rarely, a salivary fistula may occur in instances where the gland was partially removed. 
Bruising of the neck around and below the wound, especially, in the elderly.
What does nerve damage mean?
There are three nerves that lie close to the submandibular gland that can be damaged during its removal.  Most nerve damage occurs as a result of bruising of the nerves since they are held out of the way and protected during surgery.  If nerve damage occurs it is usually temporary.  There are three nerves that can be damaged all with varying results:
Weakness of the lower lip - If bruising occurs it affects the movement of your lower lip, leading to a slightly crooked smile.
Numbness of the tongue - If the lingual nerve is bruised, it causes tongue numbness similar to the sensation after having an injection at the dentist.
Restricted tongue movement - the hypoglossal nerve is only very rarely bruised.  It is a nerve that makes the tongue move and damage can therefore result in decrease of tongue movement.
Is permanent nerve damage possible?
The majority of damage to nerves is temporary although it can take several months for them to recover.  Permanent damage is possible and usually occurs in only the most difficult cases.
If a salivary gland is removed will I be left with a dry mouth?
The removal of one submandibular gland will not have an impact on the amount of saliva that you produce.  There are many other salivary glands left in and around the mouth that will still keep it moist. 

I / We have been given an opportunity to ask questions about my condition, alternative forms of treatment, risks of non treatment, the procedures to be used, and the risks and hazards involved, and I/we have sufficient information to give this informed consent. I/We certify this form has been fully explained to me/us, and I/we understand its contents. I/We understand every effort will be made to provide a positive outcome, but there are no guarantees.

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Click for pictures of submandibular gland resection.
FAQ about  submandibular gland resection.