What is salivary gland surgery (include type of anesthesia)?
The major salivary glands, the glands that generate and empty saliva into the mouth, are three pairs: submandibular glands, sublingual salivary glands and parotid glands. Thus, salivary gland surgery is the removal of any of these glands. The anesthesia during the procedure will depend on the gland to be removed: if it is a major salivary gland, such as the parotid gland, general anesthesia; if it is a minor salivary gland, local anesthesia.
Why is salivary gland surgery performed?
It is generally performed to remove tumors growing in these glands and to analyze them. It is estimated that more than 70% of these tumors are benign (non-cancerous), but any lump detected must be analyzed.
The salivary glands can also present other pathologies, among which stand out sialolithiasis, which is the obstruction of the salivary glands due to the presence of calcium stones that do not allow the saliva to flow out and cause inflammation of the affected salivary gland, and sialadenitis, which is the infection of the salivary glands, which can be an effect of sialolithiasis, or be caused by a virus or bacteria.
What does salivary gland surgery consist of?
There are several surgical techniques depending on the gland to be operated:
- Parotidectomy: is the removal of the parotid glands. It can be superficial, which is performed when the tumor is over the facial nerve and generally removes the tumor without affecting the nerve, or total, which is performed when the tumor surrounds or grows towards the facial nerve, so that both the tumor and the affected tissue and parts of the nerve have to be removed. In both cases, the procedure consists of making a cut in front of the ear and down the neck to access the tumor and remove it.
- Submandibular sialoadenectomy: consists of making an incision below the jaw line to access the gland and remove the gland and possibly the surrounding lymph nodes.
- Sublingual gland surgery: an incision is made through the mouth to remove a cyst called a ranula.
- Surgery of the minor salivary glands: consists of making a cut in the area where the gland is located in order to access and remove the tumor, the soft tissue and the affected bone area.
In all surgeries, the area is closed with sutures once the affected tissue is removed. In some cases, temporary drains may be needed to remove fluids, such as saliva or blood.
Preparing for salivary gland surgery
Prior to surgery, the specialist may perform a physical examination including your medical history, do a blood test, order x-rays and discuss which medications can and cannot be taken.
Post-procedure care
Immediately after surgery, the specialist observes your facial movements by asking you to smile or make facial gestures and explains how to care for the drain (if you have one). Once at home, it is important to follow the doctor’s instructions on wound care and drainage. It may also be necessary to return to the center to remove the sutures. Once removed, the area should be washed with mild soap and water.