Salivary gland tumor
This section contains information on the following:
1. Normal salivary glands
2. Parotid lump
3. Investigations
4. Parotidectomy
5. Complications
6. Submandibular gland diseases
1. What are salivary glands?
Salivary glands secrete saliva. There are 2 types – major and minor. Major glands are the parotid and submandibular glands. There are 2 parotid glands, one on each side, roughly in the area between the ear lobe and jaw bone. Similarly, there are 2 submandibular glands, one on each side, under the front portions of the jaw bone. There are several minor salivary glands inside the mouth.
2. What is a parotid lump?
A lump in front of the ear lobe is usually a parotid lump. In general, it is caused by a benign growth. Rarely, it may be due to cancer.
3. What tests are needed?
A thorough clinical examination is a must. In order to know better about the nature of the lump (i.e. whether it is benign or malignant), a scan (ultrasound, CT or MRI) along with a needle sample (biopsy) are required.
4. What next?
Any parotid lump, even if it looks benign, is better removed. This is because 1) it tends to keep growing and make later surgery more challenging, 2) may harbor a small focus of cancer that cannot be picked up by the needle sample, and 3) may turn malignant with time. Surgical removal and detailed study of the removed tumor would confirm the true nature of the lump.
Parotidectomy is the surgery done to remove parotid tumors. An incision will be made which runs from in front of your ear and down into your neck. This incision heals very well and in time the scar becomes barely noticeable. You can expect to go home in a day or two.
5. What are the risks with parotid surgery?
Parotidectomy in skilled and experienced hands is very safe with minimal complications. The surgery involves finding the nerve that moves one side of the face (facial nerve) and carefully and meticulously dissecting (peeling) the tumor and surrounding parotid tissue from the facial nerve branches. Because the nerve branches are handled, however carefully, some patients have a temporary and mild weakness of the facial muscles that fully recovers in a matter of days. Permanent weakness is exceedingly rare in expert hands.
6. What problems can occur in submandibular glands?
These glands can be blocked by stones in their drainage duct, causing pain and swelling particularly on eating. If amenable, the stone can be removed from inside the mouth with a simple procedure. If not, the gland may have to be removed.
Submandibular glands can also be involved by benign and malignant tumors. While a needle biopsy and scan may be useful, surgical removal is needed to confirm the nature of the lump.
As with parotid surgery, submandibular gland removal in expert hands is safe. The gland is closely related to the branch of the facial nerve that supplies the corner of the mouth. During surgery, stretching of the nerve is common. This often results in a temporary and slight drooping of the corner of mouth on smiling, which fully recovers in a matter of days. Permanent injury should be exceedingly rare.