Salivary glands produce saliva, essential for digestion, mouth lubrication, and tooth protection. It is secreted through ducts. Surgery may be considered for blockages, infections, or tumors, especially when non-surgical treatments fail or a diagnosis is needed.
Understanding Salivary Gland Surgery
The human body has three main pairs of salivary glands: parotid (largest, in front of/below ears), submandibular (beneath jaw), and sublingual (under tongue).
Surgical approaches vary depending on the specific gland and condition. Parotidectomy, the removal of part or all of the parotid gland, is common for tumors. Submandibular gland removal involves an incision below the jawline. Sublingual gland surgery is less common, performed for cysts or stones. The surgery’s complexity is influenced by the gland’s anatomical location and its proximity to important nerves and blood vessels.
Potential Risks and Complications
Salivary gland surgery carries potential risks and complications. General surgical risks include bleeding (sometimes requiring transfusion) and infection at the surgical site. There is also a risk of adverse reactions to anesthesia, such as nausea, vomiting, or severe systemic responses.
A primary concern, especially with parotid gland surgery, is facial nerve damage. It passes through the parotid gland, controlling facial expressions. Injury can result in temporary or permanent facial weakness or paralysis, impacting eye closure and smiling. Damage can range from mild weakness to complete paralysis.
Frey’s syndrome, or gustatory sweating, is another complication of parotidectomy. It causes sweating and flushing on the cheek near the surgical site when eating. It occurs when damaged nerve fibers regenerate and connect inappropriately with sweat glands instead of salivary glands. It is bothersome but not dangerous.
A salivary fistula, a leakage of saliva through the incision, may occur. It usually resolves but may require drainage or intervention. Numbness or altered sensation around the incision or on the earlobe is common, often temporary, due to sensory nerve disruption. The original condition (e.g., a tumor) may recur, requiring further treatment.
Minimizing Surgical Risks
Minimizing surgical risks involves careful planning and execution by the medical team and patient. Selecting an experienced surgeon, especially one specializing in head and neck surgery, is key. These surgeons understand the complex head and neck anatomy, including the facial nerve’s path, reducing nerve injury risk.
Pre-operative assessments reduce risk. Evaluations include imaging (MRI, CT scans) to map the gland and abnormalities, plus biopsies to determine the condition. These help the surgical team anticipate challenges and plan the safest approach. Intraoperative techniques, like continuous facial nerve monitoring, are used during parotidectomy to identify and protect the nerve.
Patient health influences surgical outcomes. Patients are advised to optimize health before surgery, managing chronic conditions or quitting smoking. Adhering to pre-operative instructions (e.g., fasting, medication adjustments) contributes to a safer experience.
Recovery and Post-Operative Care
Recovery varies based on the gland and procedure complexity. Patients experience pain and discomfort at the surgical site, managed with prescribed medication. Swelling and bruising around the incision are common and usually subside within weeks.
Wound care is important for recovery, preventing infection and promoting healing. This involves keeping the incision clean and dry; a temporary drain may be placed to remove fluid. Patients are advised to avoid strenuous activities for weeks to allow healing.
Follow-up appointments monitor recovery, remove sutures or drains, and address concerns. They also check for long-term complications or recurrence. Adhering to post-operative instructions contributes to a smoother recovery and favorable long-term outcome.