This leaflet has been designed to improve your
understanding of your forthcoming treatment and contains
answers to many of the common questions.

If you have any other questions that the leaflet does not
answer or would like further explanation please ask a
member of the medical or nursing staff.
What is the Sublingual Gland?

The sublingual gland is a salivary gland about the size of
an almond that lies underneath the tongue in the floor of your mouth.

Saliva drains from it through a number of small tubes that open on the inside of the
mouth underneath the tongue.

The most common reason for removing a
sublingual gland is as a result of a
blockage to these drainage tubes.  
This can lead to a swelling of the floor of the
mouth (ranula).

What does the operation involve?

The sublingual gland is removed under a general anæsthesia.  A cut around 2cm
long (1½”) underneath the tongue on the inside of the lower teeth.  Once the gland
has been removed the incision is held together again with stitches.  These are
usually dissolvable but may take several weeks to disappear.
The length of time partly depends upon the degree of difficulty.  In an
uncomplicated procedure it will take approximately 30 minutes to remove the
sublingual gland.

What can I expect after the operation?

You usually need a night in hospital following the surgery.  It is unlikely to be very
sore but regular painkillers will be provided for you.  There is relatively little
swelling following
sublingual gland removal.

The removal of one
sublingual gland will not have an impact on the amount of
saliva that you produce.  There are many other salivary glands left in and around
the mouth that will still keep it moist.

Do I need any time off work?

It is usually advisable to take 1 week off from work to recover from the surgery.  
During this time you should avoid strenuous activity.

Is there anything that I need to do when I get home?

It is important to keep the wound dry for the first week following surgery.  It is
important to remember that you will not be able to drive or operate machinery for
48 hours after your general anaesthetic.

Will I have a scar?

At the time of surgery, the wound is only gently held together with a few stitches,
so initially you will see some gaps.  Please do not be concerned by this.  All cuts
leave a scar but inside the mouth, the majority of these fade with time and are
difficult to see when they are fully healed.  It will take a couple of months for your
scar to fade completely.

What are the possible problems?

This list of warnings might seem excessive to some however the legal ruling in
the case of
Chester vs Afshar (2004) would suggest that it is quite prudent /
necessary to list them.  Others might say that there isn't enough information but
where do you stop?

The following list of warnings regarding sublingual gland excision is neither
exhaustive nor is it predictive.  The most pertinent warnings have been included

Infections.  Infection is uncommon but can happen if the submandibular gland was
badly infected.  Wound infection will require antibiotic treatment.  Pus collected
under the skin may need to be drained.

Bleeding.  Bleeding is unlikely to be a problem but can occur from the blood
vessels supplying the tongue (
lingual and sub-lingual vasculature).  If it occurs, it
usually does so within the first 12 hours of surgery which is why you need to stay
in hospital overnight.

Hæmatoma.  A blood clot can collect beneath the skin (hæmatoma).  This occurs
in about 5% of patients and it is sometimes necessary to return to the operating
theatre and remove the clot and replace the drain.

Numbness of Tongue.  The Lingual Nerve, which gives sensation and taste to one
half of the tongue, runs close to the duct of the gland.  It very rarely gets injured.

However, if the
Lingual Nerve is damaged, your tongue may feel numb
immediately after the operation.  This numbness may take several months to
disappear and in a minority of patients may be permanent.

Restricted Tongue Movement.  The Hypoglossal Nerve is only very rarely
bruised.  It is a nerve that makes the tongue move.  If it were to occur, it is unlikely
to produce any noticeable disability.

Submandibular Duct Damage.  The submandibular duct is the tube that carries
saliva from the
submandibular gland into the mouth.  The submandibular gland is
salivary gland, about the size of a plum, that lies immediately below the lower
jaw at the top of the neck.

The duct runs close to the
sublingual gland before opening on the inside of the
mouth under the tongue immediately behind the lower front teeth.  If this duct is
damaged, saliva may not drain properly from the
submandibular gland and the
gland may therefore swell in the upper part of the neck.  The majority of these
swellings settle down on their own.

Will I need further appointments?

A review appointment will be arranged before you leave hospital.  We will keep a
close eye on you for several months following treatment to make sure that nothing
recurs and your symptoms settle.

Useful Website:

British Association of Oral & Maxillofacial Surgeons
Sublingual Gland Removal
Last Updated 13th July 2011