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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (2): 334-339. doi: 10.19723/j.issn.1671-167X.2025.02.018

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Clinical outcomes of partial sialoadenectomy for the treatment of benign tumors in the submandibular gland

Yuanyuan YANG1,2, Shanshan ZHANG2, Guangyan YU3, Huijun YANG2,*(), Hongyu YANG2,*()   

  1. 1. Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Oral and Maxillofacial Surgery, Stomatological Center, Peking University Shenzhen Hospital & Guangdong Province High-level Clinical Key Specialty & Guangdong Province Engineering Research Center of Oral Disease Diagnosis and Treatment, Shenzhen 518036, Guangdong, China
    3. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2022-06-27 Online:2025-04-18 Published:2025-04-12
  • Contact: Huijun YANG, Hongyu YANG E-mail:yanghj8801019@163.com;hyyang192@hotmail.com
  • Supported by:
    the Sanming Project of Medicine in Shenzhen(SZSM202111012);Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(SZGSP008);Shenzhen Health and Family Planning System Research Project(SZXJ2018078)

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Abstract:

Objective: To evaluate the clinical outcomes and explore the application of partial sialoadenectomy for the treatment of benign tumors in the submandibular gland (SMG). Methods: Patients with pleomorphic adenoma of the SMG who underwent surgical treatment in the Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, from October 2017 to February 2021, were enrolled and assessed in the follow-up. Fifteen patients underwent partial sialoadenectomy (PS group), and 18 patients underwent total sialoadenectomy (TS group). Postoperative salivary secretion, degree of dry mouth, appearance changes of the face and neck, nerve damage, and tumor recurrence were compared between the groups. The volume of the glands on the operated and contralateral sides of the patients in the PS group, the saliva flow rate, and their correlations, were also analyzed. Results: There was no recurrence during the follow-up period. The whole saliva flow rate at rest in the PS group was higher than that in the TS group [(2.15±1.10) g/5 min vs. (1.35±0.97) g/5 min, t=2.208, P=0.035)], while the stimulated saliva flow rate was not significantly different. The objective feeling of dry mouth, evaluated by visual analogue scale (VAS) score, was more obvious in the TS group than in the PS group (Z=-2.244, P=0.025). In the PS group, the resting saliva flow rate of the SMG on the operated side was lower than that on the contralateral side of the same patient [(0.92±0.40) g/5 min vs. (1.18±0.40) g/5 min, t=-2.821, P=0.014], however, in the cases whose remaining SMG was more than 80% of the contralateral side, the saliva flow rate of both sides was not significantly different (t=-0.027, P=0.980). There was no significant difference in the saliva flow rate per unit volume of the gland on either side (t=-0.015, P=0.989), and the saliva flow rate of the operated SMG was positively correlated with the volume of the remaining gland (r=0.750, P=0.012). The VAS scores for neck deformity were not significantly different between the two groups (t=-0.997, P=0.319). No symptoms of nerve injury occurred in either group. Conclusion: Partial sialoadenectomy in the SMG can safely remove benign tumors while preserving glandular secretory function, with fewer complications and improved quality of life.

Key words: Benign tumor of submandibular gland, Partial sialoadenectomy, Gland-preserving surge-ry, Treatment outcome

CLC Number: 

  • R782.7

Figure 1

The surgical procedure of partial sialoadenectomy of submandibular gland A, surgical approach; B, expose the tumor; C, removed the whole tumor with a limited amount of normal gland tissue; D, partial submandibular gland was preserved, enclosure of the capsule of the residual gland to prevent salivary fistula; E, the tumor sample surrounded by limited normal glandular tissue. White arrow indicates the tumor, yellow arrow indicates the submandibular gland tissue."

Figure 2

Reconstructed image of bilateral submandibular glands after partial sialoadenectomy Green indicates the operated submandibular gland, yellow indicates the contralateral submandibular gland."

Table 1

Submandibular gland function and complications after sialoadenectomy"

Items Partial sialoadenectomy (n=15) Total sialoadenectomy (n=18) Statistics P value
Flow rate of whole saliva/(g/5 min)
  Rest 2.15±1.10 1.35±0.97 t=2.208 0.035
  Stimulated 10.63±5.67 8.12±3.96 t=1.493 0.146
VAS score
  Dry mouth 0 (0-1) 1 (0-2) Z=-2.244 0.025
  Neck deformity 2 (1-3) 2 (1-3) Z=-0.997 0.319
Nerve damage/% 0 0

Table 2

Gland volume and salivary flow rate in bilateral SMGs after partial sialoadenectomy"

Items n Operated SMG Contralateral SMG t P value
Volume of gland/cm3 10 3.60±2.31 4.67±2.29 -3.996 0.003
Saliva flow rate/(g/5 min) 15 0.92±0.40 1.18±0.40 -2.821 0.014
Saliva flow rate of per unit volume/[g/(cm3·5 min)] 10 0.32±0.18 0.32±0.18 -0.015 0.989

Figure 3

The correlation between the remaining submandibular gland volume and saliva flow rate after partial sialoadenectomy SMG, submandibular gland."

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