Endoscopic-assisted transoral submandibular sialadenectomy: a prospective evaluation of surgical, functional, and quality-of-life outcomes

Abstract Background Transcervical submandibular sialadenectomy remains the standard approach for submandibular gland excision but carries the risk of marginal mandibular nerve injury and cervical scarring. Endoscopic-assisted transoral submandibular sialadenectomy has emerged as a minimally invasive alternative that may improve visualization and reduce morbidity. Objectives To evaluate the feasibility and safety of endoscopic-assisted transoral submandibular sialadenectomy and assess postoperative functional and quality-of-life outcomes in a single-arm cohort of patients with chronic submandibular sialadenitis. Methods This prospective study included 20 adult patients with chronic submandibular sialadenitis who underwent endoscopic-assisted transoral submandibular sialadenectomy between January 2020 and December 2022. Intraoperative and postoperative complications were recorded. Functional outcomes were assessed using the Eating Assessment Tool-10 (EAT-10), Speech Handicap Index (SHI), visual analogue scale (VAS) for pain, and clinical evaluation of taste disturbance, tongue paresthesia, and tongue deviation. Oral health-related quality of life was assessed using the modified Oral Health Impact Profile-14 (OHIP-14) questionnaire. Results All procedures were completed successfully without conversion to a transcervical approach. No major intraoperative complications or permanent neurovascular injuries occurred. Minor wound dehiscence developed in two patients and oral candidiasis in one patient, all of which resolved with conservative treatment. Transient postoperative taste abnormalities, tongue paresthesia, tongue deviation, dysphagia, and speech impairment were observed but resolved completely during follow-up. Oral health-related quality of life improved significantly, with all patients demonstrating minimal-impact OHIP-14 scores at 3 months postoperatively ( p = 0.002; effect size r = 0.89). Conclusion In this prospective single-arm feasibility study, endoscopic-assisted transoral submandibular sialadenectomy was successfully performed in all patients and was associated with low morbidity, favorable functional recovery, and improved oral health-related quality of life.