Submandibular Swelling: Causes and Next Steps

Swelling on the sublingual area connected to the lower gum on the right side?

Hello, Doctor! Since the beginning of this year, I have felt a sensation of a foreign body on the right side of my throat whenever I swallow saliva, ever since I swallowed a fish bone.
I have visited both a large hospital and ENT clinics, but they all said there was no issue.
However, the sensation of a foreign body persists.
In the past month or two, I have noticed a linear swelling on the right side under my tongue connecting to the lower gum, extending towards the back of the mouth (there is also a linear structure on the left side, but it is not swollen).
What could this problem be? Which specialist should I see? Thank you.

Shelly, 20~29 year old female. Ask Date: 2015/08/16

Dr. Zeng Guanghui reply Dentistry

After swallowing a fish bone, there is a sensation of a foreign body on the right side of the throat.
Upon examination, the foreign body was confirmed to be present.
Recently, a linear swelling has been discovered on the right side under the tongue, which may indicate inflammation or a stone in the sublingual salivary gland.
It is recommended to consult an oral surgeon for further evaluation.

Reply Date: 2015/08/16

More Info

Submandibular swelling can be concerning, especially when accompanied by persistent symptoms such as a sensation of a foreign body in the throat. Based on your description, it seems you have been experiencing discomfort since the incident with the fishbone, which may have caused irritation or injury to the area. The swelling you mentioned under the tongue, particularly on the right side, could be related to several potential causes.

One possibility is that the swelling is due to a blocked or inflamed submandibular gland, which is one of the major salivary glands located beneath the jaw. This condition, known as sialadenitis, can occur when saliva flow is obstructed, often by a stone (sialolith) or due to infection. Symptoms may include swelling, pain, and sometimes fever, especially if an infection is present. The sensation of a foreign body in the throat could also be related to the swelling or irritation in the surrounding tissues.

Another potential cause could be a mucous cyst or ranula, which is a fluid-filled sac that can develop in the mouth or under the tongue. These cysts can occur when the ducts of the salivary glands become blocked, leading to the accumulation of saliva. While they are generally benign, they can cause discomfort and may require treatment if they become bothersome.

Given that you have already consulted with ENT specialists and they found no significant issues, it may be worthwhile to consider a few next steps. First, you might want to revisit an ENT specialist, particularly one who has experience with salivary gland disorders. They may recommend imaging studies, such as an ultrasound or CT scan, to better visualize the glands and any potential obstructions or abnormalities.

Additionally, if the swelling persists or worsens, or if you develop new symptoms such as pain, fever, or difficulty swallowing, it is essential to seek medical attention promptly. These could be signs of an infection or other complications that may require immediate treatment.

In summary, the swelling you are experiencing could be related to several conditions, including sialadenitis, a blocked salivary gland, or a mucous cyst. Consulting with an ENT specialist who can perform further evaluations and imaging studies will be crucial in determining the exact cause and appropriate treatment. It’s important to address these symptoms, especially since they have been persistent and are affecting your quality of life. Please do not hesitate to seek further medical advice if your symptoms continue or change.

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