Lingual Nerve Entrapment in Fused Submandibular and Sublingual Salivary Glands: A Unique Finding.

Lingual nerve (LN) is one among the 3 branches of posterior division of mandibular nerve. It might get entrapped in the infratemporal fossa by lateral pterygoid muscle, pterygospinous ligament, or lateral pterygoid plate. Its entrapment in the submandibular region has not been reported yet. A unique entrapment of LN in the fused submandibular and sublingual salivary glands in a cadaver was reported. The deep parts of the submandibular and sublingual salivary glands were completely fused with each other. The LN passed through the center of the fused part. Histologically both submandibular and sublingual salivary glands had both mucous and serous acini. Though this entrapment might not cause any functional problems, it might get injured during various surgical procedures of the submandibular region.

Are the patients with anatomic variation of the sublingual/Wharton's duct system predisposed to ranula formation?

OBJECTIVE: To evaluate ranula development according to anatomic variation of the ductal system of sublingual gland (SLG), especially the presence of Bartholin's duct. METHODS: The anatomic variation of SLG duct was prospectively investigated and compared between 55 consecutive patients with ranulas treated by SLG excision (group 1) and another 15 consecutive patients undergoing similar surgeries for other conditions (group 2). The ductal structures of SLGs and submandibular glands (SMG) were also compared between the pediatric patients and adult patients with ranulas. RESULTS: In 32 of 55 patients with ranulas (58.2%) and 1 of 15 patients without ranulas (6.7%), the SLG showed an anatomic variation of the main duct called Bartholin's duct structure (P<0.01). Seventeen of 22 (77.3%) pediatric patients with ranulas had Bartholin's ducts and 15 of 33 (45.5%) adult patients with ranulas had Bartholin's ducts (0.01

Ductal variation of the sublingual gland: a predisposing factor for ranula formation.

BACKGROUND: The purpose of this study was to evaluate ranula development according to anatomic variation of the sublingual gland (SLG). METHODS: We conducted a prospective, consecutive case series considering other clinical conditions. Twenty-five cases treated by SLG excision were enrolled in this study. The ductal structures of the SLGs of another 11 patients undergoing similar surgeries for other conditions were compared. RESULTS: In 19 of a total of 25 ranulas (76.0%) and 16 of 18 oral nonplunging ranulas (88.9%), the SLG showed an anatomic variation of the main duct called Bartholin's duct structure. Meanwhile, only 3 of 7 plunging ranulas (42.9%) had Bartholin's ducts. Bartholin's duct structure of the SLG was not found in the 11 control cases. CONCLUSION: Anatomic variation of the ductal system of the SLG might be a possible cause of ranulas. Surgical resection of the SLG is a better treatment choice for ranulas than other, more conservative treatments.

Resección parcial de glándula sublingual hipertrófica / Partial resection hypertrofic sublingual gland

El artículo reporta la resección parcial de una glándula sublingual realizada en el Centro Quirúrgico de la Clínica Especializada en Odontología de la Universidad San Martín de Porres. El paciente presentaba hipertrofia de la glándula sublingual asociada a la falta de piezas dentarias. El tratamiento realizado fue la extirpación parcial de dicha glándula, para facilitar la confección de una prótesis.

This article presents reports the partial resection of the sublingual gland made in the Surgical Center of the dentistry Specialized clinic of the San Martin de Porres University. The patient presented hypertrophy of the sublingual associated to the lack of teeth. The treatment made was the partial removal of the gland to facilitate the making of a prosthesis.

[Rare case of supernumerary submandibular gland lobes forming a complex with the sublingual gland].

In the sublingual/submandibular gland complex (L/M complex hereafter), the submandibular gland process adjoins the sublingual gland. Therefore, it is speculated that the L/M complex in the fused state is due to excessive development of the submandibular gland process. However, we encountered a case of the L/M complex formed due to supernumerary glandular lobes (lobes A, B, and C) developing in the posterior 1/3 portion of the submandibular duct. Lobes A, B, and C showed the following macroscopic morphologies, constitutions, ducts, and histological morphologies. Lobe A was disc-shaped, and this lobe together with the major sublingual gland was wrapped with the minor sublingual gland. Lobe B was attached to lobe C, forming a cingulate lobe. Lobe B had an irregular shape and was attached to the superior area of lobe A, while lobe C was rod-shaped and attached to the posterior area of lobe B. The posterior area of lobe C was attached to the submandibular gland at the base of the submandibular duct. The excretory ducts of lobes A, B, and C joined, forming one duct, which joined the posterior 1/3 portion of the submandibular duct. The histological morphologies of lobes A, B, and C showed a predominance of serous cells over mucous cells, which was the same as the morphology of the submandibular gland. In this case, the L/M complex may have formed by the following mechanism. Supernumerary lobes A, B, and C of the submandibular gland formed in the posterior 1/3 portion of the submandibular duct, and lobe A together with the major sublingual gland was wrapped with the minor sublingual gland. Lobes B and C formed a cingulate lobe, and its posterior portion (posterior portion of lobe C) attached to the submandibular gland, resulting in a fused state.

Tumefaçöes do soalho bucal relacionadas às glândulas sublinguais em desdentados parciais e totais: estudos clínico e microscópico / Mouth floor enlargement related to the sublingual gland in edentulous and partially edentulous: clinical and microscopical studies

A tumefaçäo do soalho bucal relacionada à glândula sublingual é uma entidade que tem sido pouco enfatizada na literatura e foi descrita inicialmente por Campos, em 1996, como uma hiperplasia da glândula sublingual. Ocorre em pacientes com perda de dentes posteriores inferiores e pode causar problemas na adaptaçäo de próteses totais ou parciais inferiores. O objetivo deste trabalho foi definir as principais alteraçöes microscópicas e a epidemiologia das tumefaçöes do soalho bucal. Foram removidas 24 glândulas sublinguais de 19 pacientes, 15 do gênero feminino e quatro do masculino, com idade variando de 48 a 74 anos e média de 57 anos. A indicaçäo para cirurgia foi o traumatismo sobre a regiäo no soalho bucal ou para possibilitar a adaptaçäo de próteses. O material obtido foi corado com H.E., Tricrômico de Mallory e P.A.S. Das 24 glândulas sublinguais removidas, seis foram consideradas microscopicamente normais, apesar do aspecto clínico alterado. Nas 18 glândulas alteradas, observamos as seguintes alteraçöes: 1) Atrofia acinar e aumento no número de ductos e formaçöes ductiformes. 2) Fibrose intersticial e retençäo de muco intraductal em 17 casos. 3) Discreto infiltrado mononuclear e diminuiçäo do tecido linfóide em 16 casos. 4) Infiltraçäo de tecido adiposo em 15 casos. 5) Oncocitose em cinco glândulas. Ocorrem principalmente em mulheres após a quarta década de vida, sempre associadas com ausência de dentes posteriores inferiores. Sugerimos que as tumefaçöes do soalho bucal em desdentados parciais ou totais sejam consideradas entidade nosológica

Malposed sublingual gland in the anterior mandible: a variant of Stafne's idiopathic bone cavity.

This article reports a case of an asymptomatic, ill-defined radiolucency in the anterior mandible in the region of the central and lateral incisor teeth, found on routine roentgenographic examination. A labial mucoperiosteal flap was raised under local anesthesia. A portion of the lingual plate and inferior border of the anterior mandible were missing, and the space was occupied by the sublingual gland extension. The entrapped sublingual gland was removed and the histological diagnosis confirmed. The mucoperiosteal flap was sutured back in position. Healing was uneventful.

Cervical ranula arising from a projection of the sublingual gland through the mylohyoid muscle.

A case of cervical ranula is presented, which originated from a projection of the sublingual gland into the suprahyoid region. A diagnosis of cervical ranula could not be established preoperatively because there was no intraoral involvement of the ranula. A cervical approach was used, and the correct diagnosis was made during the operation.

A new mutation involving the sublingual gland in NFS/N mice. Partially arrested mucous cell differentiation.

A new mutation in mice affecting the mucous cell differentiation of the sublingual glands is described. The normal mouse sublingual glands are mucus-secreting and virtually all the acinar cells differentiate to mucus-rich cells by the day of birth. In contrast, all endpieces of newborn mutant mice consisted of acini of immature cuboidal cells. However, normal mucous cells, staining intensively with mucin-specific stains such as Alcian blue at pH 2.5 or mucicarmine, appeared in the mutant mice from an early age singly or in groups in a small number of acini, and their number apparently increased with age to occupy over 30% of the total acinar cells. Ultrastructurally, irregular secretion granules of varying electron-density, distinct from ordinary sublingual mucin granules, were frequently observed in the cytoplasm of the immature acinar cells in the mutant phenotype. The genetic analysis showed that a single autosomal recessive gene determined the observed abnormality. This is the first salivary gland mutation and will provide a critical model for the study of salivary mucous cell differentiation.

A bilateral, superficial location of human sublingual glands: report of a case.

During a routine dissection of a cadaver, the unusual, completely superficial position of both sublingual glandular masses was noticed. Histologically, the glandular masses consisted of a group of minor sublingual glands. It is suggested that the existence of a wide gap between the anterior and posterior parts of the mylohyoid muscle, which was revealed during further dissection, was the primary embryologic anomaly that was responsible for the unusual location of the glands.