Surgical Treatment of Benign Submandibular Gland Tumor
Surgical removal of a benign submandibular gland tumor requires complete excision of the lesion while protecting adjacent vital structures — the facial nerve branches, lingual and hypoglossal nerves, facial artery, and Wharton's duct. The technical challenge lies in achieving clear margins around the tumor capsule without opening it and without sacrificing the residual gland.
This protocol covers the operative management of a benign submandibular gland tumor approached through a minimally invasive extracapsular technique, preserving the residual glandular tissue and all surrounding neurovascular structures.
Surgical approach — partial overview
The technique described is a harmonic scalpel-assisted minimally extracapsular dissection (HS-MECD), performed under general anaesthesia through a small submandibular incision sized to the tumor. It is a less invasive alternative to total gland excision for eligible tumors, with particular attention to marginal facial nerve identification and capsule integrity. The full procedural algorithm — including dissection sequence for superficial versus deep tumor locations, margin requirements, and closure steps — is detailed in the complete protocol.
References
DOI: 10.1177/0300060519892783
- For benign SMG tumours of <4 cm, HS-MECD represents a less invasive technique than TGE and affords patients increased postoperative functionality.
- Advanced surgical instruments were applied for performance of HS-MECD, which represents a highly functional technique.
- A smaller submandibular incision was made according to the tumour position and size.
- The skin flap was elevated to expose the SMG, and the marginal branch of the facial nerve was identified and preserved.
- Once the tumour was located, harmonic scalpels were used for dissection around the tumour capsule.
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