title: Preservation of the facial artery in excision of the submandibular salivary gland.
abstract: BACKGROUND
  The accepted method for submandibular gland excision traditionally includes ligation of the facial artery (FA) as suggested by a host of surgical atlases. Preservation of the FA may be significant in reconstructive procedures of the head and neck and its ligation may altogether be obviated.
  
  
  OBJECTIVE
  Prospective feasibility study of FA preservation in submandibular gland excision.
  
  
  METHODS
  Patients undergoing excision of the submandibular salivary glands from September 1999 through August 2001 were prospectively included. The FA was dissected and only its glandular branches ligated. Exclusion criteria were primary benign or malignant tumors of the submandibular salivary gland or metastatic disease involving the gland or level I of the neck. In cases where the primary tumor involved the floor of mouth, anterior tongue or mandible, resection of level I contents included the FA even in N0 necks.
  
  
  CONCLUSIONS
  104 patients (116 procedures) were included in the study. 81 patients underwent resection of the gland with preservation of the FA. The vessel was sacrificed in 35 necks because of metastases or primary tumor and in two cases of chronic sialadenitis. One patient had a postoperative hematoma following neck dissection requiring re-exploration. The source of bleeding was not found to be related to the FA. Contrary to accepted methodology, the FA may readily be preserved in surgery of the submandibular salivary glands. We suggest preservation of the FA in all cases of procedures for benign disease and in selected cases of malignancy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Yoav P
authors.initials: YP
authors.lastname: Talmi
authors.forename: Michael
authors.initials: M
authors.lastname: Wolf
authors.forename: Lev
authors.initials: L
authors.lastname: Bedrin
authors.forename: Zeev
authors.initials: Z
authors.lastname: Horowitz
authors.forename: Shay
authors.initials: S
authors.lastname: Dori
authors.forename: Gavriel
authors.initials: G
authors.lastname: Chaushu
authors.forename: Ran
authors.initials: R
authors.lastname: Yahalom
authors.forename: Shlomo
authors.initials: S
authors.lastname: Taicher
authors.forename: Jona
authors.initials: J
authors.lastname: Kronenberg
mesh_terms: D000368:Aged; D001158:Arteries; D005145:Face / Q000098:blood supply*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D015494:Salivary Gland Calculi / Q000601:surgery; D012793:Sialadenitis / Q000601:surgery; D013363:Submandibular Gland / Q000601:surgery*; D013365:Submandibular Gland Neoplasms / Q000601:surgery