When and where will the operation be done?
What must I do in the week(s) before surgery? ( insurance, hospital, family, work)
What do I do on the day of surgery and what shall I bring to hospital?
What will happen when I go to theatre?
What will happen when I get back to the ward?
Is it a safe operation and what are the side effects?
Dr McIvor has done many sublingual operations. There is no noticeable reduction in saliva as the opposite sublingual gland and other salivary glands continue to produce.
The main risks with the operation are damage to nerves next to the sublingual gland. The lingual nerve which supplies sensation to the tongue can be affected causing tingling on that side of the tongue. This settles within a few days or weeks. Greater injury to the nerve is very unusual but is more likely if there is a tumour present requiring a wider removal of tissue in the floor of mouth. This can result in numbness and/or weakness of that side of the tongue. This has minimal if any effect on speech.
Every operation carries a small (1%) chance of bleeding in the first 6 hours or so after the procedure. This can require a return to the operating room and another anaesthetic to control the bleeding vessel.
Will it affect my face?
For standard sublingual gland surgery your face will look the same although there may be some swelling under the jaw for a few days. There may be a small drain coming out through the skin under the jaw for a day after the operation. When this is removed a small puncture wound is present under the jaw that heals over about 10 days. It is simply covered with a small sticking plaster.
Occasionally the sublingual gland problem is more extensive and extends into the submandibular area. In this situation the submandibular gland may also have to be removed through the neck via a separate incision.
Will I have a scar?
There is no external scar unless the submandibular gland is also removed. This is occasionally necessary for a plunging ranula when the sublingual gland extends too far into the neck. It is also occasionally required for the excision of a sublingual gland tumour.
What will I look like after sublingual surgery and what will I be able to do?
The wound will be in our mouth so you will look the same although there may be a small drain that comes through the skin under your jaw .
The small drain collects fluid which naturally occurs following your surgery. It is a small plastic tube which is inserted into the neck at the end of the operation and is attached to a plastic collection bottle into which the fluid drains. The drain helps to speed up wound healing and reduce infection.
The drain is not painful can be carried around with you. It will usually be removed by a nurse a day after your operation when the drainage is minimal. Drain removal is not painful.
You will feel some discomfort and stiffness around your jaw but you will be given some medication to help ease any pain and discomfort. Pain relief may be given in different ways such as injections, liquid medicine or tablets. Most patients say it was not as bad as they expected.
For your own safety it is important that you do not get out of bed on your own immediately following your operation as you may be drowsy and weak. At first when you need to use the toilet a member of staff will need to assist you with a commode or bedpan. You will soon be able to walk to the bathroom yourself.
You will have a nurse call bell within easy reach so that you can seek help from the ward staff as needed.
Will I have a sore mouth or neck?
When you wake from the anesthetic you will find that the inside of your mouth on that side is quite numb as the Dr McIvor inserts a lot of local anesthetic around the surgical area once you are asleep and prior to the operation. This not only provides good pain relief but reduces the amount of intravenous pain relief he needs to give during the operation. This helps to minimize the side effects of strong pain relief such as nausea and constipation.
You may find that your mouth is uncomfortable when you poke out your tongue or swallow. This discomfort usually settles in a few days.
You will be given medication to take home to relieve the discomfort. Please take it as described on the packet and take care not to exceed the recommended dose.
That side of your mouth may be tender to touch, with some numbness, which will gradually resolve as healing takes place.
Will it affect my eating and drinking?
As there will be an incision with sutures under the tongue it is best to have a soft diet for the first week. You will need to keep your mouth clean with frequent salt and water mouthwashes over that week.
What care do I need to take regarding my mouth wound?
As there will be an incision with sutures under the tongue it is best to have a soft diet for the first week. You will need to keep your mouth clean with frequent salt and water mouthwashes.
If the wound area becomes increasingly painful, red or swollen or you notice any swelling in the neck then please seek medical advice from Dr McIvor or your GP.
What rest do I need and when should I return to work?
You will need to take it easy while your mouth wound is healing. This means avoiding strenuous activity and heavy lifting for a couple of weeks. The wound area will gradually feel more comfortable and you will soon be able to enjoy your normal activities.
You will probably need to take one to two weeks off work depending on your occupation and the nature of your work. Dr McIvor can issue you with a note for two weeks and then you should see your GP if more time is required.
What about my medications and tablets?
Please continue to take the medication you have been prescribed and ensure that you have a good supply. If you are unsure about any of the tablets you need to take, please check this with a nurse before you go home. Repeat prescriptions can be obtained from your GP.
What follow-up will there be?
Following your discharge you will need to be reviewed in the clinic to check how your wound is settling down and to discuss the laboratory report of the resected gland. You will usually receive the date and time for this appointment through the post or by phone from Dr McIvor’s secretary. Please contact Dr McIvor’s secretary (09 4887349) if you do not receive one shortly following discharge.