Modifications of submandibular gland surgery in poorly resourced settings

Unreliable follow-up: With patients with malignant tumours and unlikely to attend regular follow-up to detect early recurrence or metastases, electively treat Levels Ia,b, IIa and III  of the neck by surgery (preferably) or radiation therapy

Unavailability of postoperative radiation therapy (PORT)

  • Most patients with salivary malignancy receive PORT (Indications for PORT)
  • Not having PORT to treat residual microscopic cancer or nodal metastases has the following surgical implications:

Palliative surgery

Hence “palliative surgery” can be recommended for selected patients

Index: Clinical Practice Guidelines for Submandibular Gland

Resource Appropriate Submandibular Gland Guideline Scenarios