title: Frequency and outcomes of submandibular gland obstruction following resection of squamous cell carcinomas in the vicinity of the submandibular duct.
abstract: BACKGROUND
  The aim of this study was to report rates, associated factors and outcomes of submandibular gland obstruction following surgery for squamous cell carcinoma in the anterior floor of the mouth (FOM) or ventral tongue without a neck dissection where resection has involved (or has been in very close proximity to) the submandibular duct.
  
  
  METHODS
  A retrospective case note review was carried out for the period January 2007 to December 2011. Only patients who received primary local surgical resection for squamous cell carcinoma of the anterior FOM or ventral tongue were included.
  
  
  RESULTS
  Fifty-two patients were analysed. Fifteen (29%) developed submandibular gland symptoms following surgery. Symptoms resolved spontaneously for 14 (93%) and 1 patient required the submandibular duct to be repositioned. Comparatively, 2 patients (13%) developed symptoms when the duct was repositioned during primary surgery. No patients had their submandibular gland removed.
  
  
  CONCLUSIONS
  Resection of small tumours associated with the FOM and ventral tongue in proximity to the submandibular duct is associated with obstructive symptoms in about a quarter of patients; this is reduced by half when redirecting the duct. Symptoms are self-limiting and self-resolving. A prospective clinical trial comparing duct repositioning with subcapsular gland excision would help clarify potential benefits and best treatment modalities.
authors.affiliation: Royal Adelaide Hospital, Australia.
authors.forename: D W H
authors.initials: DW
authors.lastname: Wong
authors.forename: A
authors.initials: A
authors.lastname: Kamisetty
authors.forename: D
authors.initials: D
authors.lastname: Lowe
authors.forename: S N
authors.initials: SN
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D013363:Submandibular Gland / Q000503:physiopathology*; D013364:Submandibular Gland Diseases / Q000209:etiology*