Running Title: Submandibular Gland Involvement by Oral Squamous Cell Carcinoma Received: August 22, 2020; Accepted: February 13, 2022 Incidence of Submandibular Gland Involvement in Oral Cancer Patients with Positive Lymph Nodes: Experience at a Tertiary Cancer Centre in South India

Background: Routine excision of submandibular gland along with level Ib lymph nodes is carried out as a part of standard neck dissections. The current study aimed to evaluate the incidence of submandibular gland involvement in oral squamous cell carcinoma cases undergoing neck dissections with clinically positive nodes. Method: We carried out a retrospective observational experiment. The records of 520 patients diagnosed with oral cavity squamous cell carcinoma, who underwent neck dissection, were retrospectively reviewed. We recorded the incidence of submandibular gland involvement by the primary tumour. Results: Metastasis to level 1 lymph nodes was found in 35.6% of the patients. The involvement of submandibular gland in our study sample was 0.96%. Conclusion: Recent literature has recommended sparing of the submandibular gland in certain cases; that is because its removal causes postoperative xerostomia with exaggeration due to radiotherapy, which is considered morbid, based on various anatomical models. However, this finding is controversial. Our study suggested submandibular gland sparing neck dissections in all subsites, except for tongue, anterior alveolus, and floor of mouth