A and b, axial highresolution mr images show mylohyoid muscle arrows in each slice. Medical records were evaluated for all dogs undergoing surgery the sublingual gland was pulled caudally and dissected until it for a cervical or sublingual sialocoele using the ventral approach, was seen coursing under the mylohyoideus muscle figure 5, from november 1995 to august 2005, at michigan state univer which was incised to gain. The histology of the gland therefore varies according to gland type. The early chapters are devoted to basic issues about the anatomy, physiology, histology and imaging of the salivary glands.
Part of the european manual of medicine book series euromanual. Keywords anatomical variation, facial artery, salivary glands. The submandibular glands lie under the jawbone, one on each side. Physiology and function of the glands with respect to the production of saliva. The sublingual glands are situated under the mucosa in the floor of the mouth, on the sides of the tongue. Minor sublingual glands drain individually into the plica sublingualis. There are many other salivary glands left in and around the mouth that will still keep it moist. Alternatively, manual expression of saliva from the salivary. The sublingual glands empty via numerous small ducts that open at the mucosa of the floor of the mouth rivinus ducts. Running outward and backward from each sublingual papilla is a ridge the plica sublingualis that marks the upper edge of the sublingual under the tongue salivary gland and onto which most of the. It may be excised by using electrocautery and blunt dissection figure 10. Knowledge of these patterns could facilitate surgical management of the gland and the submandibular gland flap. Sublingual gland ranula neoplasm sialolithiasis excision.
Pdf salivary glands surgical anatomy and approaches find, read and cite all the research you need on researchgate. Hydrogen and bicarbonate ions form carbonic acid, which forms carbon dioxide and. Katherine george, in maxillofacial surgery third edition, 2017. Sublingual glands the sublingual gland is the smallest of the major salivary glands and lies just below the floor of mouth mucosa.
In this article, we shall look at the anatomy of the. The six major salivary glands are the two parotid glands, two submandibular glands, and two sublingual glands. Histology and organization of the acini and duct systems within the salivary glands. Salivary glands are located in the head and neck and are essential for the processes of chewing, swallowing, and maintaining proper oral hygiene. Anatomy of mandible unpaired bone of lower jaw largest and strongest bone in face articulates with temporal bone at temporomandibular joi anatomy of mandible free books pdf epub anatomy of mandible.
The sublingual glands are the smallest of the three paired salivary glands and the most deeply situated both glands contribute to only 35% of overall salivary volume, producing mixed secretions which are predominately mucous in nature. A submaxillary or sublingual gland sialoadenectomy is an operation to remove that particular gland causing a specific problem. Clinical anatomy, histological features and innervation of the. Anatomic and surgical literature have demonstrated that the defects may contain sublingual or submandibular salivary tissue, fat, blood vessels, or all three components. Clinical implications of aberrant neurovascular structures. Submandibular gland carcinoma is a rare tumor thatrequires surgical. Oral and maxillofacial surgery second edition, 2007. Parotid gland anatomy the paired parotid glands are the largest of the major salivary glands and weigh, on average, 1530 g. Summary three paired major salivary glands and hundreds of minor salivary glands exist in the head and neck region. An overview to submandibular or sublingual gland surgery salivary glands can be either major large or minor small see picture below. When the stone is located within the sublingual gland, it is not difficult to identify which portion of the gland is involved using ct. Zenk introduction surgery of the major salivary glands parotid gland, submandibular gland, and sublingual gland is often challenging despite the standardization of surgical procedures in recent years and the aids now available to surgeons.
The sublingual gland embryology anatomy sublingual ducts blood supply, innervation, and lymphatic drainage minor salivary glands histology of the salivary glands control of salivation salivary gland pathology. Gaughran reported observations from dissection of 324 halfheads from 162 cadavers. Tumors of the sublingual gland and space and tumorlike and. The sublingual gland is a salivary gland about the size of an almond that lies underneath the tongue in the floor of your mouth. The sublingual gland is the smallest of the major salivary glands. The superficial part lies in the submandibular triangle, above and between the two. It has a large head anteriorly, known as the lesser sublingual gland and a smaller tail greater sublingual gland, which passes posteriorly and. Surgical anatomy the paired sublingual salivary glands are located beneath the mucosa of the anterior floor of mouth, anterior to the submandibular ducts and above the mylohyoid and geniohyoid muscles figures 5, 6, 7. The superior wall is clinically the most significant. Apr 19, 2018 abstract divided by the mylohyoid muscle, the sublingual and submandibular spaces represent a relatively small part of the oral cavity, but account for a disproportionate amount of pathological processes. The presence of a stent provides a palpable landmark during surgery to aid with dissection and mobilization of the duct, thus minimizing iatrogenic injury and hence postoperative duct stenosis and possibly. Numerous small ducts 820 open into the mouth on the summit of the sublingual fold or, in some people, join the submandibular duct. Its duct opens alongside the fraenum of the tongue, where it is easily visible, and is crossed by the lingual nerve.
Request pdf sublingual gland it is infrequent for surgery to be necessary for the sublingual salivary gland. Surgical management of cervical mucocele associated with. It passes around the posterior free margin of the mylohyoid muscle, which forms the diaphragm of the mouth and separates the cervical and oral components of the gland. Sublingual gland removal, sublingual gland excision. The sublingual gland lies in the floor of the mouth.
The parotid gland is the largest of the three paired salivary glands. Detailed anatomy of the parotid, submandibular, sublingual, and minor salivary glands, including nervous innervation, arterial supply, and venous and lymphatic drainage. When a stone is located in a duct, without a change in the gland, a stone in the sublingual gland duct may be easily misdiagnosed as. An osseous depression on the internal side of the mandible represented the external wall of the sublingual gland space. Surgical anatomy of the submandibular gland the gland is composed of a superficial part and a deep part. Chapter 1 surgical anatomy, embryology, and physiology of the. Review of the major and minor salivary glands, part 1. Slg sublingual gland, smg submandibular gland, hm hyoglossus muscle, gh geniohyoid muscle, abd anterior belly of digastric muscle, ggm genioglossus muscle. In the human, there are three chief paired salivary glands. Sublingual gland excision british journal of oral and maxillofacial. Lymph from the sublingual salivary gland drains into the. Striated and intercalated ducts are also present blood supply. They are bordered by the mandible anteroinferiorly and the genioglossus muscle posteroinferiorly. Surgical anatomy the smg has both an oral and cervical component.
Beginning with the embryology, anatomy and physiology of the salivary glands, the first section of the book discusses radiographic imaging, infections, cystic conditions, sialoadenitis and sialolithiasis, and systemic diseases. Diagnosis and management, second edition, updates the landmark text in this important discipline within oral and maxillofacial surgery, otolaryngologyhead and neck surgery, and general surgery. The thorax introduction, 3 surface anatomy and surface markings, 3 the trachea, 4 the pleura, 4 the lungs, 6 the heart, 6 the thoracic cage, 7 the thoracic vertebrae, 7 the ribs, 8 the. The three paired groups of salivary glands are named by their anatomical location. There are three pairs of major salivary glands parotid, submandibular glands, and sublingual glands. Surgical diseases of the salivary glands mag online library.
Occasionally, several of the more anterior ducts may join to form a com. Sublingual gland excision postoperative instructions. They secrete predominantly mucous saliva that is drained by a collection of 820 excretory ducts collectively termed the duct of rivinus. The sublingual glands are almondshaped and lie on the floor of the oral cavity. Transcutaneous excision of the submandibular and sublingual. The sublingual gland consists mostly of mucous acini capped with serous demilunes and is therefore categorized as a mixed mucous gland with a mucous product predominating. Surgical oncology lecturer of surgical oncology nci cairo universi slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Salivary gland diseases surgical and medical management. Tumors or masses of the salivary glands usually require surgical therapy.
The sublingual glands are the smallest of the major salivary glands and rarely develop tumours, but tend to be malignant cancer when they do develop. The sublingual gland is surprisingly large and is located immediately deep to the mucosa just anterior to the submandibular duct in the anterior floor of mouth. These entities are traditionally separated into congenital, infectiousinflammatory, vascular and neoplastic aetiologies. Sublingual gland excision peds iowa head and neck protocols. A general anesthetic with nasal intubation is essential. Consideration 1 evaluation consideration 2 consent for surgery preoperative preparations printed copy of the consent and last clinical note should be displayed in the operating.
The sublingual glands are drained by 820 excretory ducts called the ducts of rivinus. There are six major salivary glands and hundreds of minor salivary glands. The sublingual gland is the smallest of the major salivary glands and sits on the mylohyoid muscles just beneath the mucosa of the floor of the mouth. The gland receives its blood supply from the sublingual and submental arteries. They are situated underneath the tongue, bordered laterally by the mandible and medially by genioglossus muscle of the tongue. Vascular clinical anatomy of the submandibular gland. Bernstein l, nelson rh 1984 surgical anatomy of the extraparotid distribution of the facial.
Surgical anatomy and access to the sublingual gland. Accessory salivary tissue in the mylohyoid boutonniere. Surgical anatomy of the lymphatic drainage of the salivary glands. November 6, 2014 university of california, san francisco. Anatomy, head and neck, sublingual gland statpearls ncbi. Parotid gland relations internal structures and surgical. Diagnosis and management offers comprehensive coverage of all aspects of this topic. Sublingual gland operative techniques in otolaryngologyhead. The anatomy of the head and neck region is complicated by a number of important nerves and structures. The removal of one sublingual gland will not have an impact on the amount of saliva that you produce.
The sublingual gland is a complex of major and minor salivary glands, which occupies much of the submucosa of the floor of the mouth extending posteriorly to the second molar region. There are four pairs of major salivary glands in both cats and dogs. Single or multiple glands may be absent or hypoplastic. Submandibular salivary gland revisited from a surgical. Ducts of the sublingual glands are called bartholins ducts. Written by wellestablished clinicians, educators, and researchers in oral and maxillofacial surgery, this book brings. The submandibular gland lies beneath the floor of the mouth and drains via whartons duct and opens near the lingual frenulum. It is usually advisable to take 1 week off from work to recover from the surgery. Aside from the sublingual gland, the sublingual space is also comprised of the deep portion of the submandibular gland, the submandibular duct, the lingual arteryvein, and the lingual branch of the mandibular division of the trigeminal nerve cn v3. Imaging of the sublingual and submandibular spaces insights. Article in french obradovic o1, bogdanovic d, pesic d, cvetkovic v, petrovic d, dozic s.
The sublingual gland structure vasculature innervation. Written and edited by expert surgeons in collaboration with a worldrenowned anatomist, this exquisitely illustrated reference consolidates surgical, anatomical and technical knowledge for the entire human body in a single volume. The aim of this study is to describe in depth the precise anatomy of the vascular supply of the submandibular gland, trying to determine the existence of patterns of glandular vascularization. Imaging the floor of the mouth and the sublingual space. Complications of surgery of the salivary glands and. Pdf mandibular and sublingual sialocoeles in the dog. Structures at risk of injury are the submandibular duct. Numerous ducts can be seen secreting saliva along the margin of the sublingual folds. Commoncauses of lingual nerve palsy are thirdmolar surgery, localanesthetic dental injection, and sublingual surgery 2, 3. B, axial highresolution mr images show mylohyoid muscle arrows in each slice. Bartholins major sublingual gland may drain via a single duct into the. Neck dissections of formaldehyde preserved human cadavers. Nodal metastasis in salivary gland malignancies has important clinical implications.
Removal of the submandibular and sublingual glands requires indepth knowledge of the anatomy and scrupulous technique for the purposes of limiting the functional and aesthetic damage, which is unjustifiable above all in the treatment of benign lesions sialodenitis, lithiasis. Surgical anatomy, embryology, and physiology of the salivary glands. Chapter 31 the salivary glands surgical anatomy of the. As such the anatomy of the floor of mouth is not well taught or. Identification of the submandibular duct using a probe, stent, and more recently sialendoscopy 1 is required. The sublingual gland is positioned above the mylohyoid muscle and below the floor of mouth mucosa. Head and neck surgery salivary gland and duct anatomy ucsf sialendoscopysalivary duct surgery course november 6, 2014 salivary gland and duct anatomy parotid gland and stensens duct submandibular gland and whartons duct sublingual gland and duct system minor salivary glands function of salivary glands food digestion. The floor of the mouth a slight fold called a sublingual papilla, from which the ducts of the submandibular salivary glands open. Aug 07, 2019 viral or bacterial infections of the sublingual salivary gland are treated with antibiotics, salivary gland massages, and in some cases, surgical interventions. The parotid gland is a major salivary gland in many animals. A and b, axial highresolution mr images show mylohyoid muscle arrows in. These secretions are important in lubricating food, keeping the oral mucosa moist and initial digestion.
The only drainage of the mucocele will not result in longterm resolution so. Surgery on the floor of the mouth can be exacting as a result of limitations in access. Surgical anatomy of parotid gland surgical anatomy of submandubular gland surgical anatomy of sublingual gland various surgical approaches. Surgical treatment of parotid gland tumors is sometimes difficult because of the anatomical. Abstract the present study aimed to highlight the characteristic anatomical, morphometrical, as well as, histochemical features of the major salivary glands sg in dogs. The sublingual caruncle is a small papilla near the midline of the floor of the mouth on each side of the lingual frenum. Located in the preauricular region and along the posterior surface of the mandible, each parotid gland is divided by the facial nerve into a superficial lobe and a deep lobe fig. Aplasia of the salivary glands is a rare condition that usually affects the parotid and submandibular glands. The minor salivary glands are found inside the mouth, just under the surface including the lips, cheeks and top of the mouth soft palate. The sublingual glands lie bilaterally in the floor of the mouth and within the sublingual folds. Important structure that run through the parotid gland.
Surgical anatomy, morphometry, and histochemistry of major. This wall represents a main surgical access to the gland. The sublingual is the smallest of the paired major salivary glands, being about one fifth the size of the submandibular. The nodes drain into the deep cervical and jugular chains bailey, 2006. Preface to the thirteenth edition, xiii preface to the first edition, xv acknowledgements to the thirteenth edition, xvii acknowledgements to the first edition, xix about the companion website, xxi part 1. Imaging of the sublingual and submandibular spaces. Jun 26, 2014 surgical anatomy of salivary glandssurgical anatomy of salivary glands dr. Plunging ranula transoral resection sublingual gland aided with sialendoscopy with histopathology. It is situated in the floor of the mouth beneath the sublingual folds of mucous membrane. Surgical anatomy of salivary glandssurgical anatomy of salivary glands dr. Anatomy, function, and evaluation of the salivary glands. The parotid gland is the largest and drains via stensens duct opposite the second molar.
Dec 20, 2017 diagnosis of cervical mucocele with the involvement of right sublingual and submandibular salivary gland associated with ranula was made. Pdf salivary glands surgical anatomy and approaches. The glands form a shallow groove on the medial surface of the mandible known as the sublingual fossa. The sublingual glands are salivary glands that lie on the floor of the mouth anterior to the submandibular glands. Consequently, surgical dissection within the fascia of the smg poses the least risk to the marginal mandibular nerve. It consists of the sublingual mucosa and a sublingual fold. The largest of these ducts, the major sublingual duct is bartholin duct. Review of the major and minor salivary glands, part. Facial nerve dissection during parotid surgery could now be performed with. However, most stones 75% 85% are located in a sublingual duct. The salivary glands arise as epithelial buds in the oral cavity between week 6 to 7 ga week 8 to 9 and extend into the underlying mesenchyme. Based on the surgical anatomy of the major sg, surgical excision of the parotid sg may be the most challenge due to vital blood vessels and nerves invading its parenchyma the branches of the facial nerve, the maxillary and. Unpaired bone of lower jawlargest and strongest bone in facearticulates with temporal bone at temporomandibular joint, consists of.
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