Submandibular Gland

What are Submandibular Glands?

Submandibular glands are paired glands and the major salivary glands. This pair of salivary glands is located on each side of the jaw particularly under the jawbone.

The submandibular glands are also known as submaxillary glands which are important in shaping the salivary system. The primary function of which is to control the saliva being released into the areas of the mouth. It is composed of mucous cells that are active and responsible for producing saliva thereby functions in keeping the mouth or the oral cavity well hydrated. The submandibular gland is also important in the digestive system as its serous cells are responsible for producing salivary amylase that facilitates the breakdown of starch in the mouth. The submandibular glands are also composed of mucin cells that lubricate the pieces of food to facilitate easy passage through the esophagus. The mucous cells contained in the submandibular glands also help in lubricating the throat.

The submandibular glands produce fluid that is thicker that what is being produced by the salivary glands. The characteristic of the fluid secreted by the submandibular glands makes it potential for the formation of stones which can block or obstruct the salivary duct.

Submandibular Gland Anatomy

The submandibular glands are a pair of salivary glands that sit under each side of the lower jaw. It is basically round in shape lying in front of the sternomastoid muscle. Both the submandibular glands are separated into superficial lobes and deep lobes further separated by the mylohyoid muscle. The submandibular glands are about the size of a walnut or about 2 inches or 5cm with a weight of approximately 15 grams and are responsible for producing about 70% of the total saliva in the body. It is also considered to be thinner than the other salivary ducts or have walls that are thinner compared to the parotid duct.

The larger part of the submandibular gland is located in the submaxillary triangle extending towards the digastricus and to the rear of the stylomandibular ligament. Each of the submandibular glands is divided into superficial lobes and deep lobes. The superficial lobes contain most of the submandibular glands and where the mylohyoid muscles dart below the superficial lobes. The deep lobe on the other hand comprises the smaller portion of the submandibular glands.

Submandibular glands are composed of several secretory cells which have their own function in the body system. The mucous cell is the most important type among the several secretory cells and is the primary product of the submandibular glands. These mucus cells lubricate the chunk or pieces of food that are swallowed thereby facilitating easy passage of food through the esophagus.

The serous cells on the other hand are also important secretory cells of the submandibular glands. It has a key role in the metabolism of the body. The function of serous cell is in the production of salivary amylase which helps in the breakdown of starch in the mouth.

The blood supply of the submandibular glands is from the branches of the maxillary and lingual arteries while the veins follow the path of the arteries. The secretory action of the submandibular glands on the other hand is directly coordinated by the parasympathetic nervous system and indirectly by the sympathetic nervous system.

Submandibular gland Pain

Submandibular pain occurs when there is an aberration in the secretion of the saliva through the salivary duct. The aberration in the secretion of the saliva is often the result of an obstruction in the salivary duct as a result of the accumulation of thick saliva. Submandibular glands produce saliva that is thicker than the saliva produced by the salivary gland. The secretion of the saliva through the submandibular duct is also difficult due to its upward opening or the uphill flow.

Submandibular pain also occurs when there is the presence of infection from either a bacteria or virus. The infection is often caused by the obstruction in the submandibular gland resulting in diminished flow of saliva or inflammation, which later causes the bacteria to accumulate and result to infection. The diminished flow of saliva can also cause the food particles to remain in the mouth as the saliva primarily helps in washing the food down the esophagus. Infection is often the result of a reduction in the production of saliva. There are medical conditions as well which can cause pain and inflammation of the submandibular glands such as the onset of mumps, dehydration, malnutrition and tumor to name a few. Submandibular pain on the other hand has no major impact to the health and is often a minor occurrence that resolves on its own.

Submandibular gland Swelling

The most common problem of submandibular gland is blockage or obstruction in the submandibular duct. The saliva produced by the submandibular gland is thicker than that produced by the salivary gland. The viscosity of the saliva produced by the submandibular gland has often resulted in its accumulation in the submandibular duct, which later form to salivary duct calculi and which will later result to blockage or obstruction.

The saliva produced by the submandibular glands contains chemicals that can cause the saliva to crystallize. The formation of the crystals or stones is responsible for blocking the submandibular duct that can impede the secretion of the saliva in the mouth. When the blockage occurs, submandibular duct will later swell and cause pain and discomfort.

The blockage of the submandibular ducts will also invite bacteria to thrive and overload of the bacteria will result to swelling of the submandibular gland associated with pain.

Excision

Excision of the submandibular gland is necessary when inflammation or swelling becomes persistent. Surgical removal of the gland is indicated for calculi or stones that remain stuck in the submandibular gland despite the different methods to dislodge the formed stones. It is also indicated for submandibular gland with lump formation. Excision is often the recommended treatment when the submandibular gland problem causes undue discomfort and pain to the patient.

Excision of the submandibular gland is done with the patient under local or general anesthesia depending on the severity and extent of the blockage. The incision is generally made in the neck exactly below the jaw where the submandibular glands are located. The procedure usually takes about an hour and the patient is usually asked to stay in the hospital for 1 to 2 days from the time of surgery.