58237 Surgical Treatment

SURGICAL TREATMENT OF SALIVARY GLAND LESIONS

Presented by Irmawati

Madherisa PaulitiIsti Daristivia

SURGICAL TREATMENT OF SALIVARY GLAND LESIONS

1. Removal of Sialolith from Duct of Submandibular Gland

2. Removal of Mucus Cysts a. Mucocele b. Ranula

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

Submandibular gland is common site of occurrence (70–80%) than sublingual and parotid gland.

Symptoms : Pain in region of the gland and spread to the floor of the mouth, tongue, pharynx, and cervical area & Swelling of the gland

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

Clinical photograph of case

Occlusal radiograph showing sialolith in duct of submandibular salivary gland

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

Arrow points to swelling as a result of the sialolith

TREATMENT IS SURGICAL AND CONSISTS OF EXCISION OF THE SIALOLITH FROM THE DUCT

The position of the sialolith in the duct, and the incision on the mucosa,underneath which the sialolith is localized

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

Exposure and preparation of the duct of the salivary gland

after incision on mucosa

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

Ligation of the duct posterior to the sialolith, in order to avoid distal displacement of the sialolith

duringsurgical procedure

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLAND

e. Exposure and removal of the sialolith using hemostat and curette

REMOVAL OF SIALOLITH FROM DUCT OF SUBMANDIBULAR GLANDf. The orifice of the duct is not sutured

SIALOLITH AFTER REMOVAL

REMOVAL OF MUCUS CYSTS MUCOCELE

“Mucocele” is the clinical term used to describe the mucus extravasation phenomenon due to trauma of the minor salivary gland

Mainly occurs at the mucosa of the lower lip

REMOVAL OF MUCUS CYSTS MUCOCELE

Clinically Painless, smooth round or oval swelling, Its color is normal or slightly bluish, its size ranges from a few milli meters up to 2 cm.

Treatment is surgical and entails excision of the lesion

1. Local Anesthesia

2. Elliptical incision around cyst with scalpel

3. Diagrammatic illustration of completed

incision

Treatment is surgical and entails excision of the lesion

TREATMENT IS SURGICAL AND ENTAILS EXCISION OF THE LESION

4. Lesion is grasped with hemostat and is dissected

using scissors

5. Final step in removal of cyst from underlying soft

tissues

TREATMENT IS SURGICAL AND ENTAILS EXCISION OF THE LESION

6. Surgical field after removal of lesion

TREATMENT IS SURGICAL AND ENTAILS EXCISION OF THE LESION

7. Undermining of mucosa of wound margins with blunt

scissors

TREATMENT IS SURGICAL AND ENTAILS EXCISION OF THE LESION

8. Operation site after placement of sutures

REMOVAL OF MUCUS CYSTS

RANULAWhat is Ranula ??

REMOVAL OF MUCUS CYSTS RANULA

Ranula is essentially a retention cyst that is due to obstruction or trauma of the duct of the sublingual or submandibular salivary gland, resulting in extravasation and retention of mucus, thus presenting as a mucus retention cyst and the mucus extravasation phenomenon

REMOVAL OF MUCUS CYSTS RANULA

Ranula is located in the floor of the mouth and is usually unilateral, with a diameter ranging 1–3 cm

Swelling with a normal or bluish, problems during speech, mastication,and deglutition

TREATMENT TO REMOVEBLE OF CYSTS RANULA

The ranula is treated surgically, principally with the method of marsupialization1. Local anesthesia

TREATMENT TO REMOVEBLE OF CYSTS RANULA

2.Excision of portion of lesion includes the

overlying oral mucosa and superficial wall of

cyst

3. Suturing of oral mucosa and margins of

cystic wall with interrupted sutures

TREATMENT TO REMOVEBLE OF CYSTS RANULA The wound remains open or is covered by

iodoform gauze that is stabilized with sutures, while healing is achieved by secondary intention

THANK YOU

QUESTION1. What is the other diagnose of this case (sialolith) ?

(jumiati question)

Answer :

The other diagnose is Tumor of mouth floor

2. What the spesific different between ranula and

mucocele ? (marini andriyana question)

Answer :

Mucocele is the clinical term used to describe the

mucus extravasation phenomenon due to trauma

of the minor salivary gland and ranula is

essentially a retention cyst that is due to

obstruction or trauma of the duct of the sublingual

or submandibular salivary gland

3. Can we use panoramik to identify the sialolith ?

(andre kusuma qusetion)

Answer :

We think no, because if we use panoramik we

cannot see the sialolith, because sialolith location in

back of mandible.

4. What the different between ranula, mucocele, and

another cyst ? (siti nur azizah question)

Answer :

Ranula and mucocele location in saliva gland than the

other cyst is not in saliva gland but can spread in apical of

teeth, in alveolar bone of maxila and mandible.

5. What the etiology of sialodensitis ?

(Jamilah ibrahim question)

Answer :

This disease is caused due to infection so as to

form white purulent secretions and condensed milk.

The bacteria involved Staphylococus aereus,

Streptococcus pneumonia, Escherecia coli,

Haemophylus Influenza.

6. Why the sjorgen syndrome can be the etiology of

sialodensitis ? (Jamilah ibrahim question)

Answer :

Because the patient of sjorgen syndrome have high

viskositas of saliva. So this condition makes easier to

calcified the saliva and being the stone of saliva gland.