(Parotidectomy; Submandibular Sialoadenectomy; Sublingual Gland Surgery)
Definition
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
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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
Reasons for Procedure
Salivary glands can become infected and blocked. They can also 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
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- 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 between 2 structures.
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
What to Expect
Prior to Procedure
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 medications up to one week before the procedure.
Anesthesia
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.
Description of the Procedure
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.
Parotidectomy
There are 2 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 reached by making a cut in front of the ear and into the neck.
Submandibular Sialoadenectomy
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.
Sublingual Gland Surgery
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.
Minor Salivary Gland Surgery
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.
How Long Will It Take?
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.
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Post-procedure Care
At the Care Center
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
During your stay, the care center staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
At Home
When you return home, do the following for a smooth recovery:
- Follow your doctor’s instructions for caring for your wound and drain.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- You may also need to return to the doctor to have the sutures removed. After the sutures are out, clean the area with mild soap and water.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the care center. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, a lot of bleeding, or discharge from the surgery site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you were given
- Spitting or vomiting blood
- New, unexplained symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Cancer Society http://www.cancer.org
CANADIAN RESOURCES:
Canadian Society of Otolaryngology—Head and Neck Surgery http://www.entcanada.org
References:
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/content/salivary-glands
Accessed July 29, 2013.
Last Updated: 5/23/2014