Name of the Procedure:

Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental

Summary

In this procedure, an external incision is made under the chin (submental area) to drain an abscess, cyst, or hematoma that has formed in the floor of the mouth. This helps to alleviate symptoms and prevent further complications.

Purpose

The main goal is to remove the infected fluid (abscess), clear out a fluid-filled sac (cyst), or drain collected blood (hematoma) to reduce pain, prevent spread of infection, and facilitate healing.

Indications

• Swelling or pain in the floor of the mouth
• Difficulty swallowing or speaking
• Visible lump or mass under the chin
• Fever or signs of infection
• No response to antibiotic treatment

Preparation

• Fasting for at least 6-8 hours before the procedure if general anesthesia is used
• Discontinuation or adjustment of certain medications as advised by the physician
• Blood tests or imaging (like CT scans or MRI) to locate and assess the abscess, cyst, or hematoma

Procedure Description

1. The patient will be positioned comfortably, and the area under the chin will be cleaned and sterilized.
2. Local or general anesthesia will be administered for pain management.
3. A small incision will be made in the submental area to access the abscess, cyst, or hematoma.
4. The contents will be drained, and the cavity may be cleaned with a sterile solution.
5. A drain may be placed to continue allowing fluid to escape and prevent re-accumulation.
6. The incision will be closed with sutures and dressed with sterile bandages.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeon (usually an oral and maxillofacial surgeon)
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)
• Supporting staff

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve damage causing numbness or loss of sensation
• Scarring at the incision site
• Allergic reaction to anesthesia
• Recurrence of abscess or cyst

Benefits

• Relief from pain and swelling
• Improved ability to eat, speak, and swallow
• Reduced risk of spreading infection
• Fast recovery and quick return to normal activities

Recovery

• Keep the incision area clean and dry
• Take prescribed antibiotics and pain medications as directed
• Avoid strenuous activities and follow dietary restrictions if advised
• Follow-up appointment to check healing and remove any drains or sutures
• Full recovery typically takes 1-2 weeks

Alternatives

• Antibiotic therapy alone (may not be effective for large abscesses or cysts)
• Needle aspiration (less invasive but may not fully resolve the issue)
• Intraoral incision and drainage (may be used if the abscess is easily accessible from inside the mouth)

Patient Experience

• The patient may experience mild discomfort or pain post-procedure, which is manageable with prescribed painkillers.
• Some swelling and bruising are expected but should subside within a few days.
• Adhering to post-operative care instructions will help in a smoother and faster recovery process.