OBJECTIVE

To increase the effectiveness of surgical treatment of patients with sialolithiasis and benign neoplasms of submandibular salivary glands via alternative surgical approach.

MATERIAL AND METHODS

Twenty patients underwent resection of submandibular salivary between March 2021 and January 2023 due to sialolithiasis with parenchymal calculi and cystic lesion of submandibular glands. Age of patients ranged from 27 to 77 years (mean 51 years). Surgery was performed through intraoral approach with endoscopic assistance. Inclusion criteria: no previous cancer and surgical submandibular interventions.

RESULTS

Mean hospital-stay was 7 days, surgery time — 120 min. Half of patients denied any chronic comorbidities that was confirmed by appropriate records. Other ones had previous gastrointestinal diseases and dyslipidemia. In all cases, we mobilized facial arteries from gland tissue and displaced them posteriorly. Only small vessels were cauterized for adequate hemostasis. In most cases, lingual nerve was located superficially and visualized immediately after incision of oral mucosa. In 7 patients, this nerve was localized deeper and displaced back by posterior part of sublingual gland, as well as submandibular gland in some cases. Postoperative complications consisted of partial paresthesia of unilateral half of the tongue with feelings of numbness, tingling and slight burning of terminal part of the tongue. Tongue sensitivity recovered within 2-6 months in all patients. There were no disorders in tongue mobility.

CONCLUSION

Intraoral approach for resection of submandibular gland is a good alternative to traditional laterael cervical approach in available endoscopic equipment and adequate surgical experience. It is a competitive, feasible and safe approach for maxillofacial surgeons.