Submandibular Space Abscess: A Clinical Trial for Testing a New Technique

Objective. In this study, the authors compare the external cervical approach with their new minimally invasive technique of intraoral drainage for submandibular space abscesses. Study Design and Setting. In a randomized clinical trial, 40 patients with submandibular abscess entered the study in Amiralam Hospital of Tehran. Subjects and Methods. Subjects were randomly divided in 2 groups of the classic external approach with skin incision in the submandibular area and the intraoral approach for abscess drainage. The data, including demographic details, need for a repeated surgery, days of postoperative hospitalization, scar formation, and possible complications, were recorded and analyzed. Results. The patients required an average of 5.5 and 5.4 days of postoperative intravenous (IV) antibiotics in the intraoral and external approaches, respectively, and were discharged from the hospital 1 day after the cessation of the IV antibiotics. There was no significant difference between the 2 groups in terms of postoperative hospitalization and days of intravenous antibiotics administration. No patients had weakness in their marginal mandibular nerve or skin scarring postoperatively in the intraoral approach group. Conclusion. This study reveals that submandibular abscess in selected cases can be successfully treated with an intraoral drainage approach, which is a better choice than the external technique in terms of better cosmetic outcome. Postoperative care in these patients is much easier because there is no need for daily irrigation and dressing of the wound. Also, there is possibly no risk for injury to surrounding nerves.