Submandibular sialadenitis presenting as Ludwig's angina.

Previous descriptions of Ludwig's angina have focused on the odontogenic etiology and the absence of gland involvement. Incision and drainage of the involved fascial spaces without excision of the submandibular gland has traditionally been the recommended surgical treatment. Two case reports of edentulous patients illustrate acute submandibular sialadenitis spreading onto the fascial spaces described in association with Ludwig's angina. Surgical procedures included incision and drainage, along with excision of the submandibular gland. In select cases clinically resembling Ludwig's angina where submandibular sialadenitis is the etiology, we advocate that gland excision be included with a definitive incision and drainage procedure.