Salivary Gland Issues: Recurrence After Sublingual Cyst Removal

Sublingual gland mucocele

Hello doctor, three weeks ago I had a mucocele removed, but two weeks post-surgery I noticed what seemed to be a small blister, and now three weeks later I suspect it has recurred.
I would like to know if, in this situation, the only option is to remove the sublingual gland? Will this cause loss of taste due to nerve damage? Could it also result in injury to the submandibular gland? Thank you.

Xiao Nu Hai, 20~29 year old female. Ask Date: 2016/08/31

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there are still relapses, surgery is recommended.
A bagging procedure can be performed, which generally does not cause damage to the nerves or submandibular glands.
However, it is advisable to discuss the actual situation and details further with the surgeon.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2016/08/31

More Info

When it comes to salivary gland issues, particularly after the removal of a sublingual cyst (often referred to as a ranula), it is not uncommon for patients to experience recurrence. The recurrence of a cyst or the formation of a new cyst can occur for several reasons, including incomplete removal of the cyst, the presence of residual cystic tissue, or the underlying condition that led to the cyst formation initially.

In your case, having undergone surgery three weeks ago and now noticing what appears to be a recurrence of a cyst is concerning. It is essential to follow up with your healthcare provider for a thorough evaluation. They may recommend imaging studies, such as an ultrasound or MRI, to assess the area and determine the nature of the new formation. If it is indeed a recurrence of the cyst, further surgical intervention may be necessary.

Regarding your question about whether the only option is to remove the sublingual gland, it is important to note that while removal of the gland may be necessary in some cases, it is not always the first line of treatment. The decision to remove the sublingual gland (sublingual sialadenectomy) depends on various factors, including the size and nature of the cyst, the symptoms you are experiencing, and the potential for complications.
One of the significant concerns with surgery in this area is the risk of damaging the nerves that control taste and sensation. The lingual nerve, which runs close to the sublingual gland, is responsible for taste sensation in the anterior two-thirds of the tongue. Damage to this nerve during surgery can lead to altered taste sensation or even taste loss. However, the risk of nerve damage can often be minimized with careful surgical technique and experience.

Additionally, there is a risk of injury to the submandibular gland (submandibular sialadenectomy) during surgery for the sublingual gland, especially if the anatomy is distorted due to the presence of a cyst or previous surgery. This could lead to complications such as dry mouth or further salivary gland dysfunction.

In summary, if you suspect a recurrence of a cyst after your recent surgery, it is crucial to consult with your surgeon or an ear, nose, and throat (ENT) specialist. They can provide a comprehensive evaluation and discuss the best course of action, which may include monitoring, further imaging, or surgical options. It is also essential to discuss any concerns you have about taste sensation and the potential risks associated with surgery to make an informed decision about your treatment plan.

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