TRANSORAL EXCISION OF SUBMANDIBULAR GLAND JIHCHIN LEE MD

TRANSORAL EXCISION OF SUBMANDIBULAR GLAND 經口下頜腺切除李日清 JIH-CHIN LEE MD PHD Dept. of Otolaryngology-Head and Neck Surgery Tri-Service General Hospital

Submandibular Gland: Location & Function � 60% saliva, chewing and digesting food and preventing tooth decay � autonomic, or “involuntary, ” nervous system. � Submandibular triangle

傳統手術的問題 �頸部留疤 � 面神經分枝受損（7. 7% permanent） � Residual Wharton’s duct Leonardo & Cosme Morbidity associated with removal of the submandibular gland. J Craniomaxilofac Surg 1992; 20: 216 -219

下頜腺手術注意事項 � Nerve �Hypoglossal N. �Lingual N. �Marginal mandibular N. � Vascular structures �Facial artery & vein

Chen et al. Head Neck 2006; 28: 1014 -1017

Literature Review 1. 2. 3. 4. 5. 6. 7. 8. Downton D, Qvist G. Intra-oral excision of the submandibular gland. Proc R Soc Med 1960; 53: 543– 546. Smith AD et al: Excision of the submandibular gland by an intraoral approach. Plast Reconstr Surg 2000; 105: 2092 -2095. Hong KH, Yang YS: Intraoral removal of the submandibular gland: A new surgical approach. Otolaryngol Head Neck Surg 2000; 122: 798 -802. Guerrissi JO and Taborda G. Endoscopic Excision of the Submandibular gland by an intraoral approach. The Journal of craniofacial surgery 2001, 12: 299 -303. Weber SM, Wax MK, Kim JH: Transoral excision of the submandibular gland. Otolaryngol Head Neck Surg 2007; 137: 343 -345. Hong KH, Yang YS: Intraoral approach for the treatment of submandibular salivary gland mixed tumors. Oral Oncol 2008; 44: 491 -495. Brown JJ and Yao M. Transoral submandibular gland removal. Operative techniques in otolaryngology 2009; 20: 120 -122. Kauffman RM et al. Transoral excision of the Submandibular gland: techniques and results of nine cases. Laryngoscope 2009; 119: 502 -507.

� 1960: Downton & Qvist

� In 2000, Hong & Kim: Intraoral removal of the SMG, a new surgical approach Hong KH, Kim YK. Intraoral removal of the submandibular gland: a new surgical approach. Otolaryngol Head Neck Surg 2000; 122: 798 -802.

� In 2007, Weber et al. Transoral excision of the SMG �Chronic sialoadenitis (n=3) �Sialolithiasis (n=2) �Pleomorphic adenoma (n=2) � Similar to Hong KH in 2000. Weber SM et al. Otol-Head Neck Surg 2007; 197: 343 -345