Accessory submaxillary gland: Two new case reports and a literature review

Abstract

Background The accessory submaxillary gland is a very uncommon anatomical variant, and incidence in the general population has not yet been quantified. The presence of pathology in these glands is rarer still, thus often going unnoticed. Material and Methods We describe two accessory submaxillary gland cases, one asymptomatic and the other with chronic sialadenitis in the main and accessory gland caused by sialolithiasis. Although our diagnosis was by computerized tomography, magnetic resonance sialography is helpful to understand and describe this entity with greater precision. Results The first case report is an incidental finding and no intervention was required. However, case report number two had clinical symptoms and required a first intervention in which the main submaxillary gland was resected, and a second intervention in which the accessory submaxillary gland was removed. Both patients are asymptomatic to date. Conclusions Awareness of the possible presence of accessory submaxillary glands and of potential variations of the excretory ducts is useful in diagnosis, as well as leading to more precise treatment for salivary pathology, and allowing surgeons to avoid complications or injuries during surgery. Key words: Accesory, submaxillary gland, submandibular gland, salivary gland, sialolithiasis, head and neck pathology.

Conventional and MR-sialography of accessory submandibular glands: A case report

“…Our review of the literature identified reports of variation in anatomy of the submandibular gland to be rare. Fewer than 15 cases of accessory submandibular glands have been reported in our review of the literature, whereas accessory lobes to the parotid gland are common and have been in 32.1% of cases examined [1 , 2] .…”

“…Two case reports have utilized MR sialography to identify accessory submandibular glands [2 , 3 , 8] . However, in both instances, there was unilateral duplication of the submandibular gland with an accessory duct joining the main submandibular duct distal to the papilla.…”

“…Anatomic variation of submandibular glands is a rare finding, unlike the more commonly variable parotid gland [1] . Abnormal findings have been characterized by unilateral duplications of submandibular ducts with or without an accessory submandibular gland [2] . These accessory (or duplicate) submandibular glands have most commonly been identified in the course of an evaluation for symptoms of sialadenitis prompting sialography that demonstrates the presence of a second duct [2 – 4] .…”

“…Abnormal findings have been characterized by unilateral duplications of submandibular ducts with or without an accessory submandibular gland [2] . These accessory (or duplicate) submandibular glands have most commonly been identified in the course of an evaluation for symptoms of sialadenitis prompting sialography that demonstrates the presence of a second duct [2 – 4] . Reports have also described a pleomorphic adenoma as the initial cause of submandibular swelling leading to identification of submandibular accessory glands [5 , 6] .…”