TREATING TUMORS OF THE SUBLINGUAL GLANDS, INCLUDING A USEFUL TECHNIQUE FOR REPAIR OF THE FLOOR OF THE MOUTH AFTER RESECTION

BACKGROUND: From a 55-year experience with about 4,000 patients treate d for salivary gland tumors, we have identified 18 patients (0.5%) who received definitive treatment for neoplasms arising in the sublingual glands. PATIENTS AND METHODS: Patient ages ranged from 35 to 76 years (median 59), and men and women were equally represented, All had mali gnant tumors, which included adenoid cystic carcinoma (9 patients), mu coepidermoid carcinoma (5 patients), and adenocarcinoma (4 patients), An asymptomatic swelling was the most common complaint (7 patients); t he tumor was incidentally discovered by a dentist in 4 others, For all patients, the treatment delay ranged from 3 to 24 months, but only 3 had lesions that extended beyond the confines of the floor of the mout h, but only 3 had lesions that extended beyond the confines of the flo or of the mouth, All were treated surgically by resections, which were peroral in 4 patients, transcervical in 5, and pull-through type (inc luding the submandibular gland) in 7, The remaining 2 patients had com posite procedures, In 3 more recently treated patients, pull-through r esections were followed by a floor-of-the-mouth repair involving trans mandibular sutures, This technique has proved useful and will be descr ibed in detail. RESULTS: Results in this small patient cohort have bee n most encouraging, Local recurrence occurred in 3 patients who succum bed 11 months, 27 months, and 21 years after initial treatment, Fourte en others remain alive and well 20 months to 20 years (median 74 month s) posttreatment, and the remaining patient was recurrence free when h e died of unrelated causes 7 years after resection. CONCLUSION: This s mall experience confirms the rarity of sublingual gland tumors and att ests to the good results in terms of function and survival that can be anticipated with adequate surgical treatment when the lesion is relat ively small.