Introduction: The surgery for salivary gland inflammatory diseases has a higher incidence of postoperative temporary paralysis than surgery for salivary gland tumors. The dissection of the facial nerve motor branches is more difficult and the nerve is exposed to the inflammatory process. The submandibular gland is the salivary tissue more frequently excised due to inflammatory disease. In these cases, temporary paralysis of the facial nerve mandibular branch is not rare and brings discomfort to the patient. The removal of the peri-glandular fat and lymph nodes is not as important as for tumor surgery. Aim: This is the reason why we started to do subcapsular gland excision for chronic submandibular inflammatory disease. After a transverse cervical incision, the capsule is opened in the gland inferior portion and dissected superiorly. The facial nerve mandibular branch is hidden by the fat and it is not identified. Study design: Prospective randomized. Material and method: The facial vein and artery are preserved after ligature of the branches to the submandibular gland. If a neoplasic disease is suspected, the procedure is changed to the traditional surgery with identification of the mandibular branch and removal of the submandibular lymph nodes. Results: In five cases, 2 females and 3 males, there were no postoperative paralysis. Other advantages were: the economy of the surgical time normally needed for identification of the mandibular branch, and preservation of the facial vessels that can be used in future in flap reconstruction.
submandibular; surgery; gland
