Treating tumors of the sublingual glands, including a useful technique for repair of the floor of the mouth after resection.

BACKGROUND

From a 55-year experience with about 4,000 patients treated for salivary gland tumors, we have identified 18 patients (0.5%) who received definitive treatment for neoplasms arising in the sublingual glands.

PATIENTS AND

METHODS

Patient ages ranged from 35 to 76 years (median 59), and men and women were equally represented. All had malignant tumors, which included adenoid cystic carcinoma (9 patients), mucoepidermoid carcinoma (5 patients), and adenocarcinoma (4 patients). An asymptomatic swelling was the most common complaint (7 patients); the tumor was incidentally discovered by a dentist in 4 others. For all patients, the treatment delay ranged from 3 to 24 months, but only 3 had lesions that extended beyond the confines of the floor of the mouth. All were treated surgically by resections, which were peroral in 4 patients, transcervical in 5, and pull-through type (including the submandibular gland) in 7. The remaining 2 patients had composite procedures. In 3 more recently treated patients, pull-through resections were followed by a floor-of-the-mouth repair involving transmandibular sutures. This technique has proved useful and will be described in detail.

RESULTS

Results in this small patient cohort have been most encouraging. Local recurrence occurred in 3 patients who succumbed 11 months, 27 months, and 21 years after initial treatment. Fourteen others remain alive and well 20 months to 20 years (median 74 months) posttreatment, and the remaining patient was recurrence free when he died of unrelated causes 7 years after resection.

CONCLUSION

This small experience confirms the rarity of sublingual gland tumors and attests to the good results in terms of function and survival that can be anticipated with adequate surgical treatment when the lesion is relatively small.