Postoperative Instructions for Submandibular Gland Excision

The Submandibular Gland: The Submandibular gland is a gland that produces saliva. You have two glands, one on each side of your face. The gland rests below the lower jaw (mandible), in front of the bend in your mandible. The gland may need to be removed for several reasons.

  • The submandibular gland may develop tumors, the majority of which are benign.
  • The submandibular gland may become repetitively blocked with stones and subsequently infected. Most of these stones cannot be seen on X ray films.
  • Three to five lymph nodes reside next to the submandibular gland. These lymph nodes drain the skin of the cheek, lips, and mouth. Some skin and mouth cancers in these areas may spread to the lymph nodes adjacent to the submandibular gland.

The Facial Nerve: The facial nerve starts in the brain, exits the skull just under the ear canal, splits into 5 thin branches, and runs through the parotid gland. This nerve controls the muscles of facial expression: forehead wrinkling, eyebrow raising, eyelid squinting and blinking, lip puckering, and smiling. One branch runs under the lower jaw to the lower lip and corner of the mouth. It may be stretched or cut during the procedure. The lower lip on the side of the surgery may be elevated for a few months after surgery. Occasionally this lip asymmetry is permanent. This may lead to some drooling out of the corner of the mouth.

POST-OPERATIVE INSTRUCTIONS

Incision: Please keep the incision dry for 2-3 days, and then gently wash the incision with soap and water 2-3 times a day as needed. You may use Q-tips dipped in peroxide to remove any dried blood over the incision. After washing, please apply a thin film of an antibacterial ointment (e.g. Polysporin). Please avoid any activity that pulls across the incision such as shaving across the incision for at least 2 weeks. (The rest of the face may be shaved.) The staples and stitches will be removed 1-2 weeks after surgery.

Drain: Some patients are discharged with a thin drain tube and oval collecting reservoir called a grenade. When the grenade looks half full or at least 2 times a day, please record the amount of fluid and then empty the grenade. Discard the fluid in the sink or toilet.

Head of Bed: Please elevate the head of your bed 30-45 degrees or sleep in a recliner at 30-45 degrees for the first 3-4 days to decrease swelling. The skin above the incision may look swollen after lying down for a few hours.

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