Prof. Dr. Birkan Taha Özkan - Dental Specialist

Salivary Gland Operation

There are 4 different salivary glands located on our bodies;

  • Parotid glands, located on the are between the ears and down to the cheeks,
  • Submandibular glands, located below the jaw on both sides,
  • Sublingual glands, below the tongue on both sides,
  • Minor salivary glands, located inside the mouth, distributed between the tissues.

What types of problems can be observed?

Surgical operations are usually performed to remove tumors, stones or infections that occur in salivary glands. Tumors occur usually around parotid or minor glands, while stone formations are observed usually at submandibular area. Stones formed in these areas are usually removed via small incisions, in cases where the stone is too large to be removed from small incisions, and these are removed from an opening incised on the neck.

Operation on parotid sg area must be performed with special considerations in mind; there are nerves passing through parotid gland which controls the small face muscles. Similar nerves also pass through submandibular glands. In some operations, these nerves or their branches might be damaged when tumor contacts the nerve, during operation or due to edema. Damage to these nerves may result in temporary or permanent damage to cheek, lip or forehead movement.

How can these complications be resolved?

If the facial paralysis post operation is the result of edema, it would pass on its own in a few days. However, if these symptoms are caused by nerve damage, then a new operation is required to repair the nerves. In some cases, the post operational issues such as sweating around ears and cheeks following a parotid gland operation can be kept and controlled with pharmaceutical treatment, this is not a situation related to the doctor’s performance or skill.

Due to location, submandibular gland removal operations can be risky; the reason being major nerves controlling the minute facial movements, tongue movements and the nerves related to taste as well as major arteries supplying the face are all passing through this salivary gland, and that these can be damaged during operation. Operations performed around submandibular gland are done so under local anesthesia or by putting the patient through general anesthesia.

What are the goals of Salivary gland operations?

The goals of salivary gland operations usually are to reinstate the salivary function of the glands, to prevent tumors from spreading through the nearby tissue or to other organs, to prevent infectious discharge and, in cases where facial symmetry is lost due to deformations, regain facial aesthetic appearance.

What complications can occur following operation?

Despite great care, certain complications may occur following operations performed on submandibular gland area. One of the most commonly observed complication is the minor damages that occur on one of the facial nerve branches where patient experiences problems controlling their lips, which will become apparent while whistling or smiling. If that nerve is cut or completely damaged, then there is not much that can be done. However, if the problems occur from pressure caused by edema on the nerves, and will eventually pass on its own.

This recovery period may take between a few days to a few months, depending on the patient’s self-care post operation.  If the nerve controlling the tongue muscles is damaged during the operation, this is a large nerve and the situation can immediately be recognized; the patient would experience problems while moving and controlling their tongue, they may experience speech or swallowing difficulties, some patients may partially lose their sense of taste. The treatment is the same as the facial nerves.