Salivary Gland Surgery

Salivary glands make the saliva in your mouth to prevent your mouth drying out and to aid the first stages of food digestion. Salivary glands have small ducts through which the saliva travels to the mouth. The most common problem with salivary glands is swelling and/or infection due to obstruction of the salivary ducts.

Obstruction is often caused by salivary duct stones, masses of crystallized minerals that accumulate in the tubes that saliva passes through. The condition is known as sialolithiasis and mainly occurs in middle-aged adults. The main symptom of salivary duct stones is pain in your face, mouth, or neck that becomes worse when eating. Other common symptoms include tenderness and swelling in your face, mouth, or neck. You may also have a dry mouth and trouble swallowing or opening your mouth.

There are three major salivary glands:

The parotid gland is a salivary gland that lies immediately in front of the ear. Saliva drains from it through a tube that opens on the inside of the cheek next to the upper back teeth. The parotid gland is most commonly operated on to remove a lump. The ducts of parotid glands can also get blocked, leading to swelling, infection and pain.

The submandibular gland is a salivary gland about the size of a plum that lies immediately below the lower jaw. Saliva drains from it through a tube that opens on the inside of the mouth under the tongue immediately behind the lower front teeth. The most common reason for removing a submandibular gland is as a result of infection that occurs if the tubes become blocked, usually as a result of salivary gland stones, causing swelling, infection and pain. You might be able to see or feel the stone under the tongue.

The sublingual gland is a salivary gland about the size of an almond that lies underneath the tongue in the floor of your mouth. Saliva drains from it through a number of small tubes that open on the inside of the mouth underneath the tongue. The most common reason for removing a sublingual gland is as a result of a blockage from salivary gland stones that can lead to a swelling.

Diagnosis and Treatment

Your consultant will examine your head and neck to check for swollen salivary glands and salivary duct stones. Imaging tests may be recommended for an accurate diagnosis.

Salivary gland ducts can be closely examined with a procedure called a sialendoscopy.  This involves a miniature telescope, known as a micro-endoscope, that is inserted into the opening of the salivary gland duct.  This allows the salivary gland ducts to be explored and small instruments can be inserted through the micro-endoscope to remove any salivary stones or debris that may be present.  The salivary glands can also be washed out with saline (salty water) or other medications such as steroids and antibiotics.  The procedure is performed under local anaesthetic.

Surgery

Salivary duct stones are often removed easily, but if you continue to develop salivary duct stones or salivary gland infections, you may need the affected gland surgically removed. You have many salivary glands so you will still have enough saliva if one is removed.

All salivary gland surgery is performed under general anaesthetic and will take approximately 30 – 45 minutes.

Parotid gland removal involves an incision immediately in front of the ear. This incision is extended either downwards into the neck or behind the ear. Submandibular gland removal involves an incision around 5cm long in the upper part of the neck just below the jaw line. Once the parotid or submandibular gland has been removed the incision is closed with stitches.  At the end of surgery a small tube is placed through the skin into the underlying wound to drain any blood which may collect. This is usually removed on the morning following surgery. Stitches will be removed around a week after surgery.

Sublingual gland removal involves an incision around 2cm long underneath the tongue on the inside of the lower teeth. Once the gland has been removed the incision is closed with dissolvable stitches.

After Surgery

You will usually need a night in hospital following surgery. There is relatively little swelling following salivary gland removal though there is likely to be some soreness which can be treated with painkillers.  It is usually advisable to take a week off work to recover from the surgery.

Need Help?

Salivary Gland Surgery is available at One Hatfield Hospital. We can book you in to see a specialist surgeon, usually within 48 hours, for an initial consultation. 

You can use your private medical insurance or pay for your Salivary Gland Surgery treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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