A sialoadenectomy is the surgical removal of a salivary gland. Located in and around your mouth and throat, these glands produce saliva. There are three pairs of major salivary glands—the parotid, submandibular, and sublingual glands—and hundreds of minor ones. This procedure is performed for specific medical reasons when a gland becomes diseased or damaged.
Medical Reasons for Salivary Gland Removal
The most frequent reason for removing a salivary gland is a tumor, which can be benign (non-cancerous) or malignant (cancerous). Benign tumors are often removed to prevent them from growing or becoming cancerous. Malignant tumors require removal to treat the cancer and stop it from spreading to other areas, such as lymph nodes.
Chronic inflammation of a salivary gland, known as sialadenitis, may also require surgery. This condition can result from repeated infections that do not respond to treatments like antibiotics. When inflammation becomes persistent, it causes pain and swelling, making removal a practical solution.
Obstructions within the salivary ducts, often caused by salivary stones (sialoliths), can also necessitate surgery. If a stone cannot be removed through less invasive methods, it may cause saliva to back up, leading to pain and infection. In these cases, removing the gland is the most effective treatment.
What to Expect During the Procedure
A sialoadenectomy is performed under general anesthesia, so you will be asleep during the operation. The surgical approach depends on which gland is being removed. For the parotid gland, located in front of the ears, the procedure is a parotidectomy. For a submandibular gland, found below the jaw, it is a submandibular sialoadenectomy.
The surgeon makes an incision in the skin to access the gland. For a parotidectomy, the incision is made in a skin crease around the ear and may extend down the neck. For the submandibular gland, the incision is made just below the jawline. For a sublingual gland, the surgeon may make the incision inside the mouth to avoid an external scar.
The surgeon then dissects the surrounding tissues to expose the salivary gland. A primary focus is preserving nerves that run near these glands, such as the facial nerve in the parotid region. After the gland is removed, the surgeon closes the incision with sutures and may place a small drain to prevent fluid accumulation.
The Recovery Process
After surgery, a short hospital stay may be necessary to monitor your recovery, ranging from same-day discharge to an overnight stay. Pain and swelling around the surgical site are normal and can be managed with prescribed medication.
Your diet will be restricted to soft foods like soups and yogurts for a period to minimize discomfort. Maintaining good oral hygiene is also necessary to prevent infection. You can return to a normal diet when your surgeon advises it is safe.
If a surgical drain was placed, it is removed within a day or two. You will need to keep the incision site clean and dry. Strenuous activities and heavy lifting should be avoided for several weeks to allow for proper healing.
Potential Complications and Long-Term Outlook
One of the main risks of parotid gland surgery is damage to the facial nerve, which controls facial muscles. An injury can lead to temporary or, rarely, permanent weakness on one side of the face. Numbness around the earlobe, jaw, or neck is also a common side effect that improves over time.
Frey’s syndrome can sometimes develop after a parotidectomy, causing sweating on the cheek while eating. This occurs when nerves regrow and mistakenly connect to sweat glands in the skin. The condition is not dangerous but can be a nuisance.
The long-term outlook is positive. Your remaining salivary glands compensate, so a persistently dry mouth (xerostomia) is uncommon unless multiple glands are removed or you undergo radiation therapy. The procedure resolves the underlying issue, such as a tumor, infection, or blockage.