Know About Your Sublingual salivary gland

Sublingual salivary gland is one of the smallest salivary gland among the major three salivary glands. The three major salivary glands are sublingual, sub mandibular and parotid salivary gland. These all three major salivary glands exist in pairs.

Anatomy

Sublingual salivary glands paired almond in shape and 3-4 gm in weight, located in the anterior part of the floor of mouth that is between mucous membrane , mylohyoid muscle and body of mandible near to mental symphasis. The head portion of these glands that drains by numerous excretory ducts i.e ducts of rivinus, directly into the oral cavity and the duct of batholin that opens into sub-mandibular duct.

Blood supply

Sulingual and submental artery supply sublingual salivary glands.

Lymphatic drainage

It drains into the submental and submandibular groups of lymph nodes.

Nerve supply

• Parasympathetic supply or secremotor fibers

These fibers arises from superior salivatory nucleus( i.e preganglionic fibers )which passes through the nervus intermedius of facial nerve and chorda tympani nerve and then join to the lingual nerve and then relay in the submandibular ganglion and from the post ganglionic fibers pass through the lingual nerves and ends by supplying sublingual gland. The sensory fibers were taken by the lingual nerve to the trigeminal nerve.

•Sympathetic supply

These fibers arises from the superior cervical ganglion and it forms plexus around the facial artery and then supply the sublingual salivary glad.

Certain common disorders of sublingual salivary gland

A. Cysts
B. Plunging ranula
C.Tumors of sublingual salivary gland

A. Cysts

Ranula is a mucus extravasation cyst of floor of mouth i.e arises from the sublingual gland and is a translucent swelling that takes on appearance of a ‘ frog’s belly ‘ i.e ranula.The word ranula derived from ‘ rana’ in Latin forfrog.

Usually ranula resolve spontaneously in some case need treatment as well. In old time usually removal of sublingual gland were preferred and it’s not easy so in recent time usually new less invasive techniques came in existence with approximately 85 % success rate by preserving the gland itself. Incision and drainage is used to preferred .

Sublingual salivary Gland

B. Plunging ranula

It’s rare form of mucus retension cyst i.e arises from the sublingual salivary glands. Here mucus is collected below the gland and perforates through mylohyoid muscle diaphragm to enter the neck.

Clinical presentation

It shows a dumbbell – shaped swelling i.e soft , fluctuant & painless in submandibular or submental region of the neck.

Diagnosis of plunging ranula

USG or MRI examination but clinched by aspirating thick yellow from cyst.

Differential diagnosis

Lymphangioma

Treatment

Removal of sublingual gland and aspirate the saliva out of the sac.

C. Tumors of sublingual salivary gland

Extremely rare and usually 90% are malignant.

Clinical presentation

Presents as a rubbery painless swelling in the floor of mouth and pain or lingual nerve paresthesia in case of high grade tumors. Punch biopsy done before thinking treatment plain.

Treatment

Require en block wide excision involving overlying mucosa & adjacent periosteum with simultaneously neck dissection based on stages of disease condition. Low threshold for adjutant radiotherapy except for low grade & stage lesions.