Excision submandibular gland (removing the large saliva gland from under the jaw) - Dr Bridget Clancy

Fast Facts

Stop aspirin and other drugs that cause bleeding one week before surgery.

Day stay or one night stay in hospital.

One to two weeks off work.

6:100 people have weakness in the muscles around the lips for a few months – it’s rare for weakness to be permanent.

What is this for and is it effective?

The submandibular gland makes saliva. The saliva enters the mouth through a tube (called the duct) under the tongue. The gland can become diseased with stones in the duct, infection or with tumours. Removing the gland will resolve these problems.

Frequently Asked Questions

What could go wrong? Is there a chance that surgery could make me worse?

Temporary side effects:

1:100 people have a temporary side effect like wound infection or bleeding. These may require antibiotics or occasionally another operation to drain the infection or blood.

6:100 people have temporary weakness or numbness. Weakness can affect the movement of one corner of the mouth and can last for up to 6 months. A nerve monitor is used during surgery to minimise the risk of damage to nerves.

Permanent side effects:

Less than 1:100 people have permanent numbness or weakness.

Could I need more surgery or treatment in the future?

The submandibular gland is one of four large saliva glands. There are multiple other smaller saliva glands around the lining of the mouth and throat. These other glands can give rise to stones, infection or tumours in the future that may need treatment.

What are the alternatives to surgery? Are they appropriate for me?

For mild problems, exploring non-surgical treatments first is wise.

For stones in the duct, eating and drinking regularly and massaging the gland during meals can help.

For lumps in the gland, an ultrasound and FNA (needle sample) are done to find out if the lump is a cancer or a benign lump. Cancer must be treated as soon as possible. Some benign tumours have a risk of becoming malignant over time and surgery is recommended within 12 months.

What if I choose not to have surgery?

For mild disease, it may be ok not to have surgery. For tumours, there may be long term consequences of not having treatment.

See should I have surgery for more information.

How should I prepare for surgery?

Stop using any supplements and medications that increase bleeding (like Nurofen) one week before surgery and follow the fasting instructions provided by the hospital. Stop smoking for as long as possible before surgery.

See preparing for surgery for more information.

When will I come into hospital? How long will the operation take? How long will I stay in hospital?

You will come into hospital on the day of surgery. The operation takes 60-90 minutes. You will go home the day after surgery.

How long will I need off work/school/sport?

You need 24 hours off driving after a general anaesthetic. You will need 1-2 weeks off work/school/sport.

Will I be awake or asleep for the operation? What kind of anaesthetic will I have?

Children and adults always have a general anaesthetic for this procedure.

See anaesthesia for more information.

How will I feel after surgery?

You will have mild pain in the throat and in the wound. Most people need paracetamol only a few times in the first day after surgery. 1:30 people feel sick or vomit after surgery.

What do I need to do to recover well?

Keep the wound dry and the dressing intact for a week. Don’t rub or apply heat packs. Eat as well as possible to aid healing. Avoid smoking.

Scar massage can improve the cosmetic appearance of the scar. You can start two weeks after surgery and continue every day for up to 6 months. Watch the video on how to do scar massage

When will I see the surgeon?

The surgeon will check on you in the recovery room, on the ward the next day and then see you in the office one week after surgery.

What should I do if I need help or advice?

You can ring the surgeon or practice nurse during business hours on 55605411. For non emergency advice outside business hours, ring the nurse at the hospital where you had surgery. For urgent care outside business hours, attend your nearest emergency department.

Click here for information about Dr Clancy’s on call schedule.

Is there any more information specific to my situation?

Your surgeon will take into consideration your work, sports/hobbies, support at home and other health problems as well as past reactions or complications with anaesthesia and surgery.

Your surgeon will answer any specific questions you ask.

After submandibular gland surgery

You need 24 hours off driving after a general anaesthetic. You shouldn’t drive on any day when you have taken strong pain relievers. Take one or two weeks off work, sport and study to recover.

What do I need to do to recover well?

The better you eat, the better you heal, especially fruit and vegetables. Keep the wound dry and the dressing intact until you see the surgeon in one week. Avoid vigorous activity (running, gym, competitive sports) and aim for some exercise like walking on most days.

Scar massage can improve the cosmetic appearance of the scar. You can start two weeks after surgery and continue every day for up to 6 months. Watch the video on how to do scar massage

What is normal? How will I feel after surgery?

The wound will be mildly painful. You may feel fatigued for a few weeks. There will be some numbness around the wound.

What is not normal?

Contact your surgeon or attend your nearest emergency department if you have:

increasing swelling in the neck.
vomiting lasting more than a few hours.
severe pain not controlled by the prescribed pain medication.
fever >38 degrees for more than 24 hours.