Salivary Gland Surgery

Salivary Gland Tumors

The purpose of saliva is to moisten the mouth, protect the teeth against bacteria and aid in the digestive process. Saliva is produced by 3 main salivary glands which include the parotids, submandibular and sublingual glands. There are also several minor salivary glands present in the mouth, lips, and cheeks. When tumors occur on the salivary glands, surgery is the most commonly recommended course of treatment.

The parotid glands are the largest salivary glands and are found on either side of the face just in front of the ears. These glands produce saliva that is secreted through the ducts into the mouth. The submandibular glands are located a little below the mandible or jaw bone. Its secretions enter the oral cavity through the floor of the mouth. The sublingual glands on either side of the tongue are the smallest of the three glands. These glands empty the secretions through the floor of the mouth as well.

Cysts or tumors leading to blockage or infection of any of these ducts is the most common cause of salivary gland problems. The symptoms include fever, pain, lump or swelling, dry mouth or a bad taste in the mouth. These symptoms are initially treated with conservative measures. Surgery is recommended however if the symptoms do not respond to conservative treatment.

Indications for Salivary Gland Surgery

Salivary Gland Surgery is indicated to treat tumors, cysts, persistent blockages and chronic infections of the salivary glands that are unresponsive to conservative treatments.

Surgical Procedure

• Salivary gland surgery is usually carried out under general anesthesia. Surgery to the parotid gland is performed by making an incision in front of the ear that extends slightly down the neck.
• The parotid is divided into a superficial and deep lobe. The facial nerve usually runs in between these two lobes.
• Care is taken to minimize injury to this nerve and its function may be monitored during the operation. If detected early, a tumor may be limited to the superficial lobe and only that lobe is removed preserving most or all of the facial nerve.
• For malignant or deep tumors, the entire gland is removed and a portion of the facial nerve may need to be sacrificed.
• Surrounding structures involved by cancer may also have to be removed. The excised portion or gland is sent to a pathologist for examination.
• Removal of the submandibular salivary gland is carried out by making a 2-inch incision below the lower jaw.
• Branches of the facial nerve running near the gland are protected as far as possible during surgery. Sublingual gland surgery is usually performed through an oral approach.
• Salivary gland surgery usually takes about 45 minutes to perform depending on the complexity.
• You may require an overnight hospital stay following the procedure.

Post-Operative Care

Following the removal of a salivary gland, you may experience numbness at the incision site. Your doctor will prescribe medications to help relieve any pain and discomfort.

The nerve function may recover after a period of time or with rehabilitation. In some cases, surgery may be necessary to improve function.

Risks and Complications

As with any surgery, salivary gland surgery may be associated with some complications which may include:

• Bleeding
• Infection 
• Facial nerve damage can cause temporary or permanent loss of facial muscle control and can result in drooping of the face. 
• Damage to other nerves in the face might cause problems with tongue movement, swallowing, and speech.
• Your appearance may be altered depending on the extent of the operation.