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

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.