Modified L-shaped surgical approach to excision of the sublingual gland.

We present a series of 1131 patients who were treated between 1981 and 2013 using the modified L-shaped angular surgical approach to excision of the sublingual gland, and describe the risks and benefits compared with the conventional approach. A total of 365 patients were treated with the conventional approach, while the other 766 have been treated since 1991 using the modified approach. There were no serious complications or recurrences during or after the operation in the modified series. There were significant differences between the two approaches in terms of injuries to the submandibular duct (p=0.03), incidence of ranula on the opposite side (p=0.02), amount of intraoperative bleeding (p=0.000), and duration of operation (p=0.000). The modified L-shaped incision is both viable and safe, and simplifies excision of the sublingual gland while protecting the submandibular duct.