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Excision of sublingual gland
CPT4 code
Name of the Procedure:
Excision of Sublingual Gland
Also known as: Sublingual Gland Removal, Sublingual Gland Excision
Summary
An excision of the sublingual gland is a surgical procedure to remove one of the salivary glands located beneath the tongue. This gland is usually removed due to chronic infection, blockages, or benign or malignant tumors.
Purpose
- Medical Condition: The procedure addresses issues such as chronic infection, sialolithiasis (salivary gland stones), and tumors within the sublingual gland.
- Goals/Outcomes: The main goal is to alleviate pain, prevent recurrent infections, or remove a suspicious or malignant lesion. Successfully excising the gland can significantly improve the patient’s quality of life and reduce symptoms.
Indications
- Recurrent infections or abscesses in the sublingual gland
- Persistent pain or swelling due to sialolithiasis
- Detection of a benign or malignant tumor in the gland
- Mucoceles (mucous cysts) forming in the gland
Preparation
- Patients are typically instructed to fast for at least 6-8 hours before the procedure.
- Adjustments to medications, especially blood thinners, may be necessary.
- Preoperative blood tests and imaging studies (e.g., ultrasound, MRI) might be required to assess the gland and overall health status.
Procedure Description
- Anesthesia: The patient is administered general anesthesia.
- Incision: A small incision is made inside the mouth, under the tongue, to access the sublingual gland.
- Excision: The gland is carefully dissected away from surrounding tissues and blood vessels using fine surgical instruments.
- Closure: The incision is closed with absorbable sutures.
Tools/Equipment: Scalpel, surgical scissors, retractors, suction devices, cautery instruments.
Duration
The excision typically takes about 1-2 hours.
Setting
This procedure is performed in a hospital or an outpatient surgical center.
Personnel
- Surgeon (Otolaryngologist or Oral and Maxillofacial Surgeon)
- Anesthesiologist
- Nursing staff and surgical technicians
Risks and Complications
- Common risks: Bleeding, infection, swelling, and bruising.
- Rare risks: Injury to nearby nerves causing numbness or altered sensation, difficulty speaking or swallowing, excessive bleeding, and adverse reactions to anesthesia.
Benefits
- Relief from chronic pain and infections
- Resolution of obstruction and restoration of normal salivary flow
- Removal of benign or malignant growths, potentially leading to improved prognosis
Recovery
- Post-Procedure Care: Patients may need antibiotics to prevent infection and pain medication to manage discomfort.
- Instructions: Avoid hot or spicy foods, maintain good oral hygiene, and rinse mouth with a prescribed mouthwash.
- Recovery Time: Typically, full recovery takes about 1-2 weeks. Patients are advised to avoid strenuous activities during this period.
- Follow-Up: A follow-up appointment is usually scheduled within a week to monitor healing and address any concerns.
Alternatives
- Non-Surgical: Management of symptoms with medications, including antibiotics and pain relievers.
- Minimally Invasive: Procedures like sialendoscopy to remove stones or dilate ducts.
- Comparative Pros/Cons: Non-surgical methods might not provide permanent relief, whereas minimally invasive techniques could be less effective if the underlying condition is severe.
Patient Experience
- During the Procedure: Patients are under general anesthesia and will not be conscious during the surgery.
- After the Procedure: Some discomfort, swelling, and a feeling of tightness under the tongue are typical; these can be managed with prescribed medications. Most patients can resume normal activities within a week, although complete healing may take a bit longer.