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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.