ATYPICALLY LOCATED SUBMANDIBULAR-GLAND DIAGNOSED BY DOPPLER ULTRASOUND

The anatomical location and relationships of the submandibular gland a re well known to most otolaryngologists and gross variations from the norm are rare. We report a case of an atypical submandibular gland loc ated 2 cm below the mandible which presented as a painful neck swellin g with non-diagnostic fine needle aspiration cytology. Using Doppler u ltrasound the mass was noted to be closely located to the facial arter y and vein and following the administration of oral lemon juice, the p eak systolic velocity of a small artery within the mass rose from 8.5 cm/s to 16.4 cm/s, confirming the tissue's salivary nature. We review the literature on using Doppler ultrasound in this area of the neck an d discuss realistic practical applications of the technique.