Implications of Oral Squamous Cell Carcinoma to Submandibular Gland: A Systematic Analysis

Objective: Submandibular Gland (SG) Located in Level ΙB Region of Neck. During neck dissection, it is routinely removed along with level ΙB lymph nodes. Less data is available to represent SMG involvement in oral squamous cell carcinoma (OSCC). Main objectives of systemic Review are to establish the rate, pattern and pathways of SMG involvement in OSCC. Data Sources: A systematic review of related article were analyzed and articles recognized through  PubMed, Scopus, Medline and Cochrane library were studied until November 2019. Review Methods: Explanatory features of main primary tumours, key management modalities, rate, pattern and pathway of SMG involvement, existence results. If existent were conveyed, subsequent PRISMA guidelines. Results: The collected information were investigated and produced 259 articles, 19 out of 259 fulfil the inclusion criteria. 2699 patients in that 3235 SMG resections is selected out of 19 articles. Sixty-four glands (1.97%) had tumour participation. direct SMG infiltration by primary tumour was most common pathway (48 of 64, 1.4%). The subsequent usual method of SMG invasion was from involved peri-glandular lymph nodes (12 of 64, 0.3%). Only 3 resected SMG out of 3235 (0.1%) had metastatic parenchymal involvement from primary tumor. Conclusion: Scarcity of SMG involvement in OSCC, SMG protection could be practicable in some patients. Decision regarding resection of submandibular glands should be done after visual examination during surgery instead of pre-planned resection. Though, extra analyses is required to assess the function of retained SMGs amongst patients who received postoperative radiotherapy.