Submandibular gland

This is a large salivary gland, lying posterior in the submandibular space, it is folded around the posterior edge of the mylohyoid muscle, and has a small, deep component lying in the posterior part of the sublingual space. At this last point, the gland forms its excretory duct, known as Whartons duct, which runs in the sublingual space, eventually piercing the mucosa of the floor of the mouth anteriorly in the oral cavity. Also, see submandibular gland.

2. Pathology

a) congenital anomalies

- agenesis of the submandibular glands is a rare congenital disorder.

b) inflammation

- commonly caused by sialolithiasis. Retro-obstructive submandibular sialadenitis may also be caused by compression or invasion of Wharton's duct in the sublingual space (Wharton's duct (VI:2), Fig. 1). Post-traumatic stricture of Wharton's duct may occur. See also sialadenitis.

c) tumoral pathology

Primary tumours of the submandibular gland are uncommon. About 40% of submandibular gland tumours correspond to pleomorphic adenoma (Fig.1). Malignant tumours occur with higher relative frequency than in the parotid gland; adenoid cystic carcinoma, adenocarcinoma head and neck and anaplastic carcinoma occur with near-identical frequency.

d) trauma

Traumatic lesions of the submandibular gland are less common than those of the parotid gland. Trauma to the submandibular gland may cause a sialocele. Postsurgical scarring in the floor of the mouth is the most common injury to Wharton's duct; it may cause retro-obstructive inflammation or atrophy of the gland.

RH