Removal of the submandibular gland by a submental approach: a prospective, randomized, controlled study.

There are few controlled studies on surgical approaches for excision of the submandibular gland (SMG). This study evaluated the benefits of a submental approach, compared with a conventional submandibular approach, for SMG resection. Twenty patients with benign SMG disorders, 12 with pleomorphic adenoma and eight with chronic sialadenitis with sialolithiasis, were resected using a submental (10) or submandibular (10) approach. The submental approach consisted of a horizontal incision on the submental skin and flap elevation to the gland, and the submandibular approach consisted of an incision along the skin crease overlying the SMG. Operation time, complications, hospital stay, cosmetic appearance and subjective satisfaction with the incision scar were compared between groups. The two groups were well matched in age, gender, marital status, and SMG disorders. Mean operation time, hospital stay and complication rates were comparable in the 2 groups. Mean patient satisfaction score was higher in the submental than in the submandibular group (8.8 vs. 5.4, P=.01), and the incision scar in the submental group was usually less visible. Compared with the submandibular approach, the submental approach can provide better cosmetic outcomes with no increases in operation time and complication rates.