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Salivary gland removal

Published by Bupa’s Health Information Team, October 2011.

This factsheet is for people who are having salivary gland removal, or who would like information about it.

A salivary gland may be removed if there is a growth in the gland, or a blockage in the salivary duct.

You will meet the surgeon carrying out your operation to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About salivary gland removal

You may need to have a salivary gland removed if you have a growth in the gland (a tumour), or if a duct has become blocked. Blockages are usually caused by salivary duct stones or a narrowing of your salivary duct. 

Depending on how much of the gland is affected, you may have all or part of the gland removed.

Your salivary glands produce saliva to keep your mouth moist. It also allows you to swallow, helps keep your teeth healthy and breaks down your food as part of digestion.

There are three major pairs of salivary glands in your mouth.

  • Parotid glands. These are the largest of your salivary glands and are located on either side of your face between your cheekbone and your jawbone in front of your ears.
  • Submandibular glands. These are smaller than the parotid glands and are located under each side of your jawbone.
  • Sublingual glands. These are the smallest of the three types and can be felt as two small lumps on the floor of your mouth underneath your tongue.

As well as these major glands, there are many other tiny salivary glands throughout your mouth and throat. These are called your minor salivary glands.

Diagnosis of a salivary gland condition

Salivary gland problems are usually first noticed as either a swelling of the whole gland or as a smaller lump within the gland. When you see your GP, he or she will ask about your symptoms and examine you. Your GP may then refer you to a surgeon with a specific interest in salivary gland diseases. This will usually be an ear, nose and throat (ENT) surgeon or an oral and maxillofacial surgeon (a doctor who specialises in the surgical treatment of conditions that affect the head, neck, face and jaw).

You may need to have a blood test and an ultrasound, CT or MRI scan. If your doctor thinks you might have a tumour, you will have a biopsy taken from the affected gland. A biopsy is a small sample of tissue. This will be sent to a laboratory for testing to determine the type of cells and if these are benign (not cancerous) or cancerous. Most salivary gland tumours are benign.

What are the alternatives to salivary gland removal?

Salivary gland tumours are usually treated with surgery. This is because the tumour needs to be removed to both confirm its type and to cure the problem. If you have a salivary duct stone, you can sometimes have it removed with a procedure known as a sialoscopy or with a small operation inside your mouth. In sialoscopy your surgeon uses a flexible tube (endoscope) to remove the stone.

Preparing for salivary gland removal

Your surgeon will explain how to prepare for your procedure. For example, if you smoke, you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

The operation is done under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during salivary gland removal?

Depending on which salivary gland you have removed, the procedure may take between 30 minutes and four hours. 

Your surgeon will make a cut into your skin. The position of the cut will depend on the type of salivary gland being removed.

  • If you have a parotid gland removed, your surgeon will make a C-shaped cut that runs from the bottom of your ear and around the edge of your jawbone. The cut is sometimes continued up the skin crease in front of your ear.
  • If you have a submandibular gland removed, your surgeon will make a cut in the upper part of your neck, just below your jawline.
  • If you have a sublingual gland removed, your surgeon will make a cut inside your mouth, under your tongue.

If there is a stone blocking a salivary duct, your surgeon may also make a cut inside your mouth to remove it.

After the affected gland is removed, the cut is closed with stitches.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You may have a fine tube running out from your wound. This will drain fluid into a bottle and is removed once there is very little coming out. For submandibular gland removal this is usually the day after surgery, but for parotid gland removal it can be between two and three days later.

You will usually need to stay in hospital until your drain is removed. You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your salivary gland removal.

General anaesthesia temporarily affects your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.

Before you go home, you will see your surgeon to discuss the outcome of the procedure and whether you need any further treatment. Your nurse will advise you about caring for your healing wounds and may arrange a date for a follow-up appointment.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should usually disappear in about two to three weeks. Non-dissolvable stitches and skin clips are removed about a week after your operation.

Recovering from salivary gland removal

It usually takes about one week to make a full recovery from salivary gland removal, but this varies between individuals, so it’s important to follow your surgeon’s advice. You may find eating and drinking uncomfortable for the first few days. Start with soft or pureed foods as they are easier to eat.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If the cuts were made outside your mouth, try to keep your wound dry for the first week after the procedure. Take care when washing and shaving your face.

What are the risks?

As with every procedure, there are some risks associated with salivary gland removal. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

You’re likely to have some bruising, pain and swelling below your jawline. You may find it painful to chew or swallow at first, and may have some loss of taste and sensation, but this is uncommon.

You will have a scar, but this will fade over time.

Complications

Complications are when problems occur during or after the procedure. General complications of salivary gland removal are listed below.

  • Infection. If you feel a burning sensation when you touch your wound, or it looks red, inflamed or swollen, contact your GP. You may have an infection and need antibiotics.
  • Nerve damage. This can be permanent and cause changes to your face or alter the movements of your tongue.
  • Frey’s syndrome. This happens when nerves that are cut during surgery reconnect abnormally with sweat glands. Your cheeks become red, flushed and you feel sweaty when you eat.
  • Build-up of saliva under your skin. If only part of a gland has been removed, saliva can leak out from the cut edge of the remaining gland into the wound and cause it to swell up. Sometimes the saliva leaks out of the wound, particularly when you eat. This usually clears up without treatment, but can take several months.

 

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: October 2011

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