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. 2024 Nov 27;16(11):e74628.
doi: 10.7759/cureus.74628. eCollection 2024 Nov.

Efficacy of Submandibular Gland Excision Versus Preservation During Supraomohyoid Neck Dissection for T1, T2, and N0 Oral Squamous Cell Carcinoma

Ranjit Karnati  1 , Sabyasachi Parida  2 , Saroj R Sahoo  2 , Amaresh Mishra  1 , Bandita Panda  3 , Varsha Madhavnarayan Totadri  4 , Subrat Mohanty  5
Affiliations

Efficacy of Submandibular Gland Excision Versus Preservation During Supraomohyoid Neck Dissection for T1, T2, and N0 Oral Squamous Cell Carcinoma

Ranjit Karnati et al. Cureus. .

Abstract

Introduction: The present study aims to observe the efficacy of submandibular gland excision vs. preservation during supraomohyoid neck dissection (SOHND) based on the postoperative outcomes for early oral squamous cell carcinoma (OSCC) with clinically N0 neck and xerostomia.

Materials and methods: A pilot study was conducted to observe the efficacy of preservation vs. excision of the submandibular gland in early OSCC in 20 cases with an age range of 18-75 years. Intraoperative blood loss and time taken for level Ib lymph node dissection were compared. Histopathologically, lymph node yield (level Ib) was also compared. Postoperative follow-up up to four weeks and xerostomia assessment were done in both groups by using the Xerostomia Inventory score and Clinical Oral Dryness Score (CODS). Continuous and categorical data and their significance level were analyzed statistically.

Results: Routine submandibular gland excision and preservation methods were used for level Ib lymph node dissection during SOHND. Comparative assessment between the two methods revealed that surgery duration and blood loss in the test group were significantly higher (p-value < 0.001) as compared to the control group. The incidence of xerostomia in both groups did not reveal any statistical difference.

Conclusion: Submandibular gland preservation during SOHND in early OSCC leads to a slight increase in the time of dissection and blood loss is negligible and appears oncologically safer. No recurrence of intraglandular lymph nodes and zero incidence of xerostomia were the follow-up conclusions of the preservation method.

Keywords: intraglandular lymph nodes; oral squamous cell carcinoma; submandibular gland excision; supraomohyoid neck dissection; xerostomia.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology issued approval KIIT/KIMS/IEC/483/2020. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Image of supraomohyoid lymph node dissection with preservation of the submandibular salivary gland (A) vs. routine submandibular gland (SMG) excision (B) during supraomohyoid neck dissection.
The circle shows the preservation of the submandibular salivary gland.
Figure 2
Figure 2. Gender distribution in the preservation method (test group) and routine method (control group).
Preservation method (test group): Submandibular gland preservation during level Ib group lymph node dissection during supraomohyoid neck dissection (SOHND). Routine method (control group): Routine submandibular gland excision during SOHND.
Figure 3
Figure 3. TNM (tumor, node, and metastasis) staging in the preservation method (test group) and routine method (control group).
See this image and copyright information in PMC

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