Introduction: There are different complications related to the submandibular gland resection, like damage to the mandibular branch of the facial nerve, lingual or hypoglossal nerve. Moreover, subjective complaints like dry mouth, altered sensation around the scar and taste alterations were described. Patients and methods: A prospective, non-randomized study was performed including 20 patients treated with submandibular gland resection. Results: The most common etiology was sialolithiasis affecting 9 (45%) patients. One (5%) patient presented a lingual nerve paresis, 2 (10%) patients presented a transient marginal mandibular branch paresis and no hypoglossal nerve alteration was observed. Factors like the size of the lithiasis (P = 0.293), size of the tumor (P = 0.445) or type of pathology (P = 0.694) were not related with neurological complications. Altered sensation in the skin around a scar was the most severely weighted problem (55% and 33.3%), and xerostomia was the second one (33% and 27.3%) at one month and at six months after surgery, respectively. Conclusion: The submandibular gland resection remains to be a safe technique with a low rate of surgical and neurological complications. However, patients should be informed about sequelae like xerostomia, altered sensation in the skin or pain around the scar, which may be discomforting. The cosmetic result can be satisfactory, but a surgical scar can be avoided with another approach. Although rare, the risk of MBFN, lingual and hypoglossal nerve damage should always be included in the preoperative information on surgical risks.
20 patients met the inclusion criteria (40 neck dissections). Just one case of a right temporal MMN weakness in the post-operative period was observed (1/40 = 2,5%). There were no cases of permanent marginal mandibular nerve weakness using the Hayes-Martin manoeuvre Conclusion: The Hayes-Martin manoeuvre is a safe way to preserve MMN during neck dissection of level IIa, regardless of the type of dissection.
Introduction: Surgical site infection (SSI) is a common complication in surgery. In head and neck surgeries, different rates are reported in the indexed literature. Nowadays, this indiscriminate use of antibiotics is associated with increased cost and risks for patients. Antimicrobial misuse has also contributed to the development of antibiotic-resistant bacteria. Patients and Methods: A total of 204 patients were included in this observational retrospective cohort study. The primary outcome of this study was to describe the rate of SSI. Wound infection was considered as SSI and was defined as any cellulitis or pus drainage requiring treatment with antibiotics. Results: Of all, 127 were included in group A (not antibiotic) and 77 in group B (antibiotic prophylaxis); 109 (53.5%) patients were male, and 97 (47.5%) were female. Four (3.14%) patients developed SSI in group A and 3 (3,89%) developed SSI in group B, being not statistically significant ( P = .592). In group A, 2 patients suffered SSI after a submandibular gland resection (SGR), 1 patient after a parotid gland resection (PGR), and another one after a branchial cleft cyst resection. In group B, 1 patient suffered SSI after an SGR and 2 after a PGR. On univariate and multivariate analyses, we did not find any variable associated with the development of SSI. Conclusion: According to our results, the prophylactic antibiotic in clean, benign head and neck surgery is not necessary. Nevertheless, physicians and surgeons should be aware that severe or even fatal SSIs might be developed, and it needs to be explained to our patient before any surgery.
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