Ultrasound in Patients With Clinically Suspected Submandibular Gland Disease

Background: The submandibular gland is quite common to be affected by various disease processes in all age groups that may be difficult to differentiate clinically. Its superficial location makes it readily accessible to ultrasound evaluation. Objective: To evaluate sonographic features of abnormal submandibular gland. Methods: Ultrasound images and medical records of patients who presented with clinically suspected submandibular gland disease at a single institution were retrospectively reviewed. Demographic data, final diagnoses, further management, and sonographic findings were evaluated. Results: Eighty-one patients were identified, 56 females and 25 males (mean [SD] age, 53 [16] years; range, 1 - 87 years). The main presenting symptoms were palpable mass (31 [38.3%]) and pain (23 [28.4%]) involving the left (30 [37.0%]), the right (27 [33.3%]), and bilateral submandibular area (24 [29.6%]). Only 6 patients (8.1%) underwent further imaging. The most common final diagnoses were acute sialadenitis (38 [46.9%]), Sjögren syndrome (14 [17.3%]), tumor (6 [7.4%]), and stone (4 [4.9%]). Submandibular glands were normal in 17 of 81 patients (21%); 9 of 17 (52.9%) had abnormal lymph nodes. Among various disease entities, a significant correlation was found between Sjögren syndrome and small gland size, stone and ductal dilatation, and abnormal lymph nodes with enlarged nodal size (P < .001). Conclusions: Two-thirds of the patients had inflammatory/infectious diseases, with tumor and stone in minority. Certain ultrasound findings can suggest diagnosis. Less than 10% underwent further imaging, suggesting that ultrasound can be used to detect and guide further management of submandibular disease.