SALIVARY GLAND DISEASE

Salivary Gland Operations

Some salivary gland problems require surgery. Dr McGuinness is a recognized expert in the management of these conditions and will advise you on the appropriate treatment option for your condition.

What are the most common operations for salivary gland problems?

Sialendoscopy

Sialendoscopy is a modern, minimally invasive procedure used to treat salivary gland stones or strictures (narrowed salivary ducts). A sialendoscope (or salivary endoscope) is a tiny tube with a camera and light source at its end. During endoscopy, this tiny tube is inserted through the opening of the salivary duct. This allows Dr McGuinness to view the salivary glands, and to remove stones or dilate strictures.

Benefits of Sialendoscopy

Sialendoscopy is a minor surgical procedure, and no incisions are required. This results in a much quicker recovery, and you are able to return to a normal diet almost immediately. Sialendoscopy preserves the affected salivary gland, and has fewer complications than open salivary gland surgery.

Sublingual Gland Excision

It is unusual for the sublingual salivary glands, located under your tongue, to cause any problems. They can occasionally leak saliva into the tissues under the tongue to form a type of cyst called a Ranula. They can also rarely form tumours. Sublingual glands can be excised with a minor surgical procedure through the mouth.

Submandibular Gland Excision

In some cases, surgery may be required to remove the submandibular gland. This could be necessary as a result of a submandibular gland tumour (benign or cancerous), recurrent stones or ongoing gland infection.

Submandibular gland excision is performed under a general anaesthetic, and takes approximately 1 hour. To remove the gland, a skin incision (around 5 cm long) is made just below your jawline.

Parotidectomy

Parotidectomy is removal of part or all of the parotid gland. This is most commonly done to remove a parotid tumour (benign or cancerous).

The parotid gland consists of 2 parts, a superficial and a deep lobe. The facial nerve, (a very important nerve that controls the movements of your face), runs between the 2 lobes of the parotid. Parotid gland removal requires extreme precision to avoid damage to this nerve. Surgery takes around 3 – 4 hours, and is performed under a general anaesthetic.

What are the main risks and side-effects of salivary gland surgery?

Pain

Some pain may be expected after salivary gland surgery. You will be given painkillers during, and for several days after the procedure. It is important to let Dr McGuinness know if you are experiencing ongoing pain.

Bleeding

Any surgical procedure carries some risk of post-operative bleeding. However, bleeding after salivary gland surgery is unlikely.

Infection

Rarely, infection may develop after surgery but this is very rare. This could require antibiotic treatment.

Scar

Any skin incision will leave a scar. This usually fades with time. The scars we leave after salivary gland surgery are generally hidden in skin creases and are usually inconspicuous.

Nerve damage

Nerve damage is a potential complication of salivary gland surgery. Temporary nerve damage may occur due to tension on the nerves during surgery. Permanent nerve damage is rare.

Following submandibular gland excision, nerve symptoms could include:

Following parotidectomy, nerve symptoms could include:

Numbness of the ear lobe and skin around the wound- this happens to nearly everyone but fades with time
Weakness of the muscles of the face due to injury to the facial nerve. Damage to the trunk of the facial nerve is extremely rare. Bruising to 1 or 2 branches of the nerve - particularly the branches supplying the lower lip - is not uncommon. Nearly all cases of weakness will recover by 3 months.
Frey’s syndrome. This causes sweating or redness of one side of the face when eating. Frey’s syndrome develops if the salivary nerve endings join with nerves that control skin sweating.

Salivary collection and fistula

After parotid gland surgery, saliva may collect under the skin of your cheek. This is usually temporary. It is easily treated by draining it with a needle, a painless procedure that can be carried out in the office.
If you require surgical removal of one salivary gland, you need not be concerned about a dry mouth after surgery. Because you have multiple salivary glands, the removal of one gland does not usually make a difference to the moisture content of your mouth.

Dr McGuinness performs all of his surgical procedures with precision and care, to ensure that you experience the best possible outcome.