Salivary Gland Excision

You have 4 large salivary glands in your neck. The salivary glands in your cheeks are the parotid glands. The salivary glands under your chin are the submandibular glands. Together, these 4 glands produce most of your saliva, but you also have tiny glands throughout your mouth that produce some saliva as well.

Salivary Gland Excision is removing part or all of one (or even 2) of these glands. It will not affect your overall saliva production.

Why does a salivary gland need to be removed?

A consultation at Texas Sinus & Snoring with Dr. Cilento and proper imaging will let you know if Salivary Gland Excision is the right solution for you. There are several reasons a salivary gland may need to be removed, here are a few:

Stones: Salivary glands are laid out like a manufacturing plant: there are microscopic assembly lines (cells) for the creation of saliva. Once the saliva is created, it flows through small ducts that fuse into bigger ducts until one large duct empties into your mouth. If the saliva has too much calcium in it, or if it doesn’t flow as quickly as normal, it is possible for the calcium molecules (which are normally present in your saliva) to get too close to one another and start to form little stones. If these stones get large, they can clog up the ducts and make it difficult or even impossible for saliva to flow past them into your mouth. This obstruction will lead to infections of the gland, swelling, and pain with eating.

Recurrent Infections: Sometimes salivary glands get infected over and over again for unknown reasons. Whatever the cause, normally the best treatment is just to remove the gland.

Benign Tumors: Salivary glands can get small or large tumors inside them just like any other organ in your body. These tumors are most likely benign. The most common tumors do continue to grow until they become very obvious (deforming) or push on surrounding structures and cause problems this way. Normally, the bigger the tumor gets, the more difficult to remove because it pushes on all of the normal tissues in the neck.

Cancer: Salivary glands can have cancer inside of them as well. Cancers in salivary glands can be slow growing or can be very fast growing and aggressive. Very rarely will cancers in salivary glands not need to be removed with surgery. It is common, however, that surgery alone may not be enough to treat cancers in salivary glands and radiation or even chemotherapy may help in your treatment.

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Parotidectomy Procedure

Parotidectomy is a procedure done under general anesthesia in a hospital. The procedure typically takes around two hours to complete. Medications that thin your blood will have to be stopped 1 week before the surgery to prevent bleeding. There will be an incision on your neck in front of your ear and coming down onto your neck in a natural crease- this incision hides very well and often is not noticed much after the procedure. All patients need drains in their necks immediately after surgery which can be removed around 3 days after the procedure.  This helps remove any healing fluid that would collect in the area. Too much fluid can make it tough for your body to heal properly and it is important to use drains to improved healing time.

Submandibular Gland Excision Procedure

Removing the submandibular gland happens under general anesthesia as well. The procedure takes around one to two hours and you normally go home the same day. Medications that thin your blood will have to be stopped 1 week before the surgery to prevent bleeding. There will be an incision on your neck parallel to your jaw line several inches below the jaw in one of your natural neck creases. Normally the incision heals well, but there are many different ways to prevent scarring. Rarely, you will need a drain after surgery to help remove excess healing fluid and decrease healing time.

Salivary Gland Surgery Benefits

Salivary gland surgery is normally medically necessary. Leaving the gland in your body if you have stones or recurrent infections could potentially lead to abscess formation and a medical emergency. We need to avoid this at all costs. Benign tumors tend to grow with time and, some of them, can even transform into cancers if left in your body too long. The benefits of removing cancer are obvious- we cannot leave something so dangerous inside of you. The great thing about salivary gland removal is that it normally goes well and recovery is relatively quick. You will not need to take medications after the procedure and should not have any effect on your overall saliva production.

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Salivary Gland Surgery Risks

All surgeries have risks of bleeding, scarring, repeat surgical procedures, and pain.  The most important risks of salivary gland surgery have to do with the surrounding structures which are dependent upon which gland is being removed.  The parotid gland sits on your cheek and is divided in half by the nerve that controls all of the movement of your face.  Normally, only the part of the gland that is between the skin and the nerve needs to be removed, but in most cases, we need to find the nerve to the face, save it and peel the tumor off it to make sure that it is not damaged.  The biggest and scariest risk of parotid surgery is temporary or permanent damage to this nerve.  A smaller risk is that the ear on the side of the surgery will be numb after the procedure.  This is relatively common as the nerve that provides sensation to that ear often runs directly through any tumors in the salivary gland.  Risks for the submandibular gland are very different than risks for the parotid gland.  The nerves that control the movement of your lower lip, your tongue movement and your tongue sensation are in the area of the submandibular gland.  Temporary or permanent damage to these nerves is always possible, but very rare.  Most patients do very well after the procedures and do not have nerve weakness of any kind.

Salivary Gland Surgery Recovery and Results

Recovery from salivary gland surgery is varied, but almost everyone goes home the same day. Everyone has some pain after the procedure and you will be given medications for this. Normally, patients do not need more than a few days of pain medications and are back to work after 1 week. The long-term results of salivary gland surgery are normally very good with few complications. The most important thing is having that salivary gland out of your body so that you can heal and go on with more important parts of your life: infection, stone, or tumor free.