Name of the Procedure:

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

Summary

This procedure involves making an incision outside the mouth to drain an abscess, cyst, or hematoma located under the jaw in the floor of the mouth. This helps to remove infected fluid or pus, alleviate pain, and prevent further complications.

Purpose

• To treat infections or fluid collections under the jaw within the floor of the mouth.
• To relieve pain, swelling, and pressure from the buildup of pus or fluid.
• To prevent the spread of infection to other areas.

Indications

• Presence of a submandibular abscess, cyst, or hematoma.
• Symptoms include severe swelling, pain, redness under the jaw, difficulty swallowing, speaking, or breathing.
• Failure of other treatments such as antibiotics to resolve the issue.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Review of medical history and current medications.
• Preoperative imaging like an ultrasound or CT scan to locate the abscess, cyst, or hematoma.
• Possible blood tests to assess overall health and infection levels.

Procedure Description

1. The patient is placed in a comfortable position, and local or general anesthesia is administered.
2. The surgeon sterilizes the area under the jaw to maintain aseptic conditions.
3. An incision is made through the skin and underlying tissues in the submandibular region.
4. The abscess, cyst, or hematoma is identified, and the surgeon carefully drains the fluid or pus.
5. The incision site may be irrigated to ensure all infected material is removed.
6. Depending on the case, a small drain may be placed to facilitate further drainage.
7. The incision is then closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and size of the abscess, cyst, or hematoma.

Setting

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

Personnel

• Otolaryngologist (ENT specialist) or oral and maxillofacial surgeon.
• Surgical nurses.
• Anesthesiologist or nurse anesthetist.

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Risk of damage to nearby nerves or blood vessels.
• Scarring at the incision site.
• Rarely, complications related to anesthesia.

Benefits

• Effective drainage of infected or accumulated fluid.
• Relief from pain and swelling.
• Prevention of further spread of infection.
• Improvement in function and comfort, usually within days.

Recovery

• Post-procedure care includes keeping the incision clean and dry.
• Prescription of antibiotics to prevent infection.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and remove any drains, if placed.
• Recovery time is typically 1-2 weeks depending on the patient's overall health.

Alternatives

• Non-surgical methods such as antibiotic therapy for early-stage infections.
• Needle aspiration as a less invasive option, though it may be less effective.
• Benefits of the extraoral approach include thorough drainage and reduced recurrence risk.

Patient Experience

• The patient will be under anesthesia and should not feel pain during the procedure.
• Postoperative discomfort is managed with pain medication.
• There might be some swelling and bruising in the area, which gradually decreases.
• Most patients return to normal activities within a few days to a week, following the surgeon's instructions.