Submandibular Lump

Where is the submandibular gland located? 

This is a paired large (major) gland producing saliva (spit) located on each side of the upper neck immediately under the mandible (jaw bone).

What lumps occur in the submandibular gland?

Both malignant and benign lumps occur in the submandibular gland. Approximately 50% of lumps in this gland are cancerous. Your surgeon may recommend performing a fine needle aspirate (needle biopsy) of the lump to find out what sort of tumour you have.

Why remove the lump?

Your surgeon may recommend surgery to remove the submandibular gland to confirm the diagnosis. Known malignant submandibular gland lumps are best treated by surgery, and in some cases radiation is recommended after surgery.

What does submandibular gland surgery/excision entail?

Submandibular gland excision is the surgical removal of the submandibular gland. The operation is performed under general anaesthesia, which means that you will be asleep throughout. The incision is placed on the side of the neck several centremetres below the mandible (jaw bone). The incision heals very well with minimal scarring.

At the end of the operation the surgeon will place a plastic tube through the skin to reduce the risk of blood clot (haematoma) collecting under the skin. You may require an overnight hospital stay following your surgery before the drain can be removed and you can go home. In some cases your surgeon may arrange for you to recuperate at home with the drain soon after the surgery. You will need 1 to 2 weeks off work.

Possible complications

  • Infection: Occasionally, the wound may become swollen, red, tender and warm to touch (cellulitis). This is treated with antibiotics. Rarely there pus may collect under the skin (abscess), which is best treated be surgically draining the pus
  • Blood clot: A blood clot (haematoma) may collect under the skin. This occurs in about 5% of patients and it is sometimes necessary to return to the operating theatre and remove the clot and replace the drain
  • Seroma: This is build up of bodily fluid occurring at the site of surgery
  • Numbness of the face: The skin of the side of the face will be numb for some weeks after the operation
  • Facial weakness: A branch of the facial nerve (marginal branch) passes over the submandibular gland and occasionally may temporarily become weak following this surgery, resulting in an asymmetrical smile
  • Tumour recurrence: Occasionally the parotid tumour may recur at any time after the surgery, regardless of the diagnosis

If you are worried about any symptoms, talk to your GP or family doctor and ask for a referral to the MercyAscot Head and Neck Service.

 

 

Symptoms to watch out for:

 - Limited ability to open mouth

 - Dry mouth

 - Fever

 - Pain while eating

 - Bad taste in mouth

 - Redness of the upper neck or side of the face

 - Swelling of the face (e.g. in front of the ears, below the jaw, or under the tongue)