SUBMANDIBULAR SWELLINGS / MASSES

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Located just below the mandible (jaw) and extending from the angle of the mandible to the midline is a triangular area that contains the submandibular gland. The submandibular gland is the second largest of the salivary glands next to the parotid gland. Most of the swelling or masses, in this area are related to the submandibular gland. These may be infective in nature or may be tumours. The submandibular triangle also contains several lymph nodes. An enlarged lymph node in this triangle may sometimes be mistaken for an enlarged submandibular gland.

Any swelling in this region needs to be investigated. A detailed history may provide clues as to whether the swelling is infective or may be a growth. It will also provide information regarding the possible pathology.

Examination will include examination of the neck to rule out other swellings and to determine the possible extent and consistency of the swelling. Often the doctor may do a bimanual examination which involves feeling the swelling both from inside the mouth and the neck. Endoscopic examination of the nose and throat is an essential part of the clinical examination.

Imaging studies such as CT scan of the neck or MRI of the neck will provide information regarding the extent and relationship of the swelling with the structures around it. This information is critical in planning surgical excision should it be necessary.

A fine needle aspiration (FNAC) which involves aspirating some cells from the swelling to have a histological diagnosis may be helpful.