42450 Excision of sublingual gland

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

1. Anesthesia: The patient is administered general anesthesia.
2. Incision: A small incision is made inside the mouth, under the tongue, to access the sublingual gland.
3. Excision: The gland is carefully dissected away from surrounding tissues and blood vessels using fine surgical instruments.
4. Closure: The incision is closed with absorbable sutures.

5. 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.