Avaliação das complicações pós-operatórias imediatas da remoção da glândula submandibular pelas vias transcervical e intrabucal

Abstract

The theme of this study is “Immediate postoperative complications resulting from removal of the submandibular gland by the intraoral and transcervical routes”. This topic was chosen because various disorders result in damage to the submandibular gland; these disorders mainly include acute and chronic sialoadenitis with or without sialolithiasis, as well as benign or malignant tumors. In the treatment of these pathological conditions, the glandular tissue can be removed without impairing the functioning of the alimentary tract. Removal of the submandibular gland is not a problem, as this gland is an isolated structure and can technically be excised without difficulty. The type of surgical technique used to treat sialolithiasis is controversial. Intraoral removal of calculi from the submandibular duct based on the possibility of functional return of the gland is not a definitive solution; there are irreversible histological changes found in excised glands and cicatricial stenosis in the submandibular gland duct. Removal of the gland is traditionally carried out by the transcervical route. This route is well established and is usually indicated when the calculus is located in the distal portion of the duct. The transcervical procedure has several complications. One controversial point is the amount of submandibular duct that should be removed. An alternative to this transcervical operative approach has been considered. Both surgical approaches, external or intraoral, are subject to complications arising from the positioning of the anatomical structures surrounding the submandibular gland. Therefore, the aim of this study is to analyze the immediate postoperative complications resulting from the removal of the submandibular gland by the intraoral and transcervical routes, based on data from the literature. The study was carried out through a systematic review of the literature, and the relevant question asked was: what are the post-operative complications and how often do they arise in operations to remove the submandibular gland using the transcervical approach and the intraoral approach? An analysis of the literature shows that the number of immediate post-operative complications is higher with the transcervical approach than with the intraoral approach, especially with regard to damage to the marginal nerves of the mandible, lingual nerve and hypoglossal nerve.