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The submandibular gland is one of the major salivary glands, the other 2 being the parotid and sublingual salivary glands. Unfortunately stones can develop in the duct that drains the submandibular gland and as a result can block the outflow to the gland.

Classically the patient complains of pain under the jaw in association with eating food and this area may swell because of the obstruction to normal saliva into the mouth. The stones are radioopaque usually therefore, they can be demonstrated on a simple XRay or an Ultrasound.

Occasionally these stones may pass into the mouth through the duct opening under the tongue. If the stones are troublesome and located in the floor of mouth then they can be removed there. If the stones are based further back and symptomatic it is better to remove the duct as an excision of the submandibular gland.

The submandibular gland is situated under the jaw line and helps produce saliva along with the parotid, sublingual and minor salivary glands. It is intimately related to the facial artery and vein as well as to three nerves. These nerves include the marginal mandibular nerve which supplies the muscles of the face mainly the lower lip, the lingual nerve that carries sensation and special taste to the tongue and the hypoglossal nerve that carries innervations to muscle of the tongue. All these nerves are in the territory of the gland and should be protected at all times during the operation.

The submandibular gland is typically removed for classically 3 reasons:

·         Tumour- Both benign and malignant tumours may grow in the gland

·         Sialadenitis- This is inflammation of the gland that typically happens as a result of stasis of secretions or stones in the duct that drains the gland

·         Diagnostic- Occasionally we are uncertain as to why there is a gland enlargement and it is useful to be able to send it for pathological examination