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Salivary Gland Surgery

(Parotidectomy; Submandibular Sialoadenectomy; Sublingual Gland Surgery)

Pronounced: sal-E-var-ee gland SUHR-jah-ree
En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Salivary glands secrete saliva into your mouth through ducts. The salivary glands are found around the mouth and throat. The main glands are:

  • Parotid
  • Submandibular—submaxillary
  • Sublingual glands
  • Smaller glands located throughout the mouth area

Salivary Glands

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This surgery is done to remove a salivary gland. There are different types of surgeries, depending on which gland needs to be operated on:

  • Parotidectomy —to remove the parotid gland
  • Submandibular sialoadenectomy—to remove the submandibular gland
  • Sublingual gland surgery—to remove the sublingual gland

Reasons for Procedure

Salivary glands can become infected and blocked. Or, they can have a tumor, stone, or other disorder. Surgery is done to treat the problem by removing part or all of the affected gland. It may also be done to remove tissue for testing, like removing a tumor to test for cancer.

Possible Complications

Complications are rare. But, no procedure is completely free of risk. If you are planning to have salivary gland surgery, your doctor will review a list of possible complications, such as:

  • Numbness of the face and ear
  • Damage to the nerve that controls movement of muscles in your face
  • Saliva drainage—Saliva may leak through the incision after it has been closed.
  • Frey’s syndrome—This happens when salivary nerve fibers grow into the sweat glands. While eating, some people may notice sweating on the side of the face where the surgery was done.
  • Bleeding
  • Infection
  • Swelling of the airway
  • Scarring
  • Fistula formation—This is an abnormal connection that may occur between the mouth, nose, throat, or skin.

Having risk factors for heart disease can increase your risk for heart attack or stroke during or after surgery. They include:

Talk to your doctor about these risks before the surgery.

What to Expect

Before the surgery, your doctor may:

  • Do a physical exam and review your medical history
  • Have blood tests done
  • Have x-rays or other imaging tests done
  • Talk to you about any medications, herbs, and dietary supplements that you may be taking—You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory medications, such as ibuprofen
    • Blood thinners
    • Anti-platelet medications

If you are having surgery on larger salivary glands, such as the parotid gland, general anesthesia may be used. This will keep you asleep and free from pain during the procedure. If smaller salivary glands are being removed, you may receive local anesthesia. Only the area that is being operated on will be numbed.

This procedure is often done in an outpatient setting. But, if your surgery is extensive or is on a larger gland, you may need to stay in a hospital.

There are two types of parotidectomy surgery. The type you will have depends on why the surgery is being done.

The facial nerve runs near the parotid gland. If you have a tumor and it is above the facial nerve, then a superficial parotidectomy will be done. The tumor and affected tissue will be removed without harming the nerve.

If you have a tumor that surrounds or grows into the facial nerve, a total parotidectomy will be done. The tumor, affected tissue, and parts of the nerve will be removed.

For both types of surgery, the gland will be accessed by making a cut in front of the ear and into the neck.

A cut will be made in the neck below the jawline. The submandibular gland, and possibly surrounding lymph nodes, will be removed. If you are having the surgery to remove a stone that has grown in the gland, the stone will also be removed.

If you are having sublingual gland surgery, it is most likely because a type of cyst, called a ranula, needs to be removed. During this surgery, a cut will be made through the mouth to remove the cyst. If the cyst is large, a cut will also be made in the neck.

If you are having surgery to remove tumors from smaller salivary glands, the doctor will make a cut in the area where the gland is located. The tumor and any surrounding soft tissue and bone that is affected will also be removed.

For all surgeries, when all tissue has been removed, the area will be closed with sutures. In some surgeries, temporary drains may be put in place to remove any fluids from the wound.

Removed tissue may be sent to a lab for testing. This is often done if a tumor was removed, since tests will determine whether the tumor is cancerous. Knowing this can help the doctor plan for your care and treatment after surgery.

This varies depending on which gland needs to be removed. Simple glands may take less than an hour to remove. Complex surgeries may take up to five hours.

Anesthesia prevents pain during surgery. You may be given pain medication after surgery.

Right after surgery, the staff may:

  • Check your facial movements by asking you to smile or pout
  • If you have a drain, show you how to care for it

When you return home, do the following for a smooth recovery:

  • Follow your doctor’s instructions for:
    • Caring for your wound
    • Caring for your drain
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • You may also need to return to the hospital to have the sutures removed. After the sutures are out, clean the area with mild soap and water.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, a lot of bleeding, or discharge from the surgery site
  • Nausea and/or vomiting that you cannot control with the medications you were given
  • Pain that you cannot control with the medications you were given
  • Spitting or vomiting blood
  • New, unexplained symptoms
RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery

http://www.entnet.org

American Cancer Society

http://www.cancer.org

CANADIAN RESOURCES:

Canadian Cancer Society

http://www.cancer.ca

Canadian Society of Otolaryngology

http://www.entcanada.org

References:

Salivary gland surgery. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Salivary-Gland-Surgery.aspx. Accessed July 29, 2013.

Salivary glands. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/salivaryGlands.cfm. Accessed July 29, 2013.

Last reviewed July 2013 by Marcin Chwistek, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.