Neck masses confined to the submental space: our experience with 24 cases

We conducted a study to identify the clinical and histopathologic features of masses confined to the submental space and to outline an approach to the diagnosis and treatment of these lesions. Our study population was made up of 24 patients-17 males and 7 females, aged 13 to 68 years (mean: 45.88 ± 8.48)-who had undergone surgery at our tertiary care center for the treatment of masses of the submental triangle. Our findings were based on a retrospective review of demographic data, signs and symptoms, diagnostic and therapeutic methods, histopathologic outcomes, and recurrences. Fine-needle aspiration biopsy and ultrasonography were performed on all patients as standard diagnostic procedures. Surgical excision was the mainstay of treatment, although abscesses were treated with local drainage and systemic antibiotics. Histopathology identified a wide variety of entities, including reactive lymphoid hyperplasia (n = 12), non-Hodgkin lymphoma (n = 3), dermoid cyst (n = 3), abscess (n = 3), sarcoidosis (n = 1), hemangioma (n = 1), and lipoma (n = 1). The clinical picture was complicated by dental problems in 9 patients and by cheilitis in 2. During a follow-up of up to 74 months, no local recurrences were detected. We conclude that lesions of the submental space are most likely to occur secondary to local and benign pathologies of the head and neck. However, malignancies or systemic diseases must also be ruled out. Careful assessment of the oral cavity and nose is important, and treatment must be based on the underlying etiology.