Lump in the salivary gland

Symptoms of salivary gland tumours may include:

• A firm, often painless lump or swelling on the floor of your mouth, in front of your ears or under your chin
• Numbness or muscle weakness on one side of your face, neck, or jaw
• Pain around the affected salivary gland
• Difficulty opening your mouth wide or moving your facial muscles
• Difficulty swallowing

Salivary gland tumours occur when cells develop changes in their DNA causing them to grow and divide rapidly. The rapidly dividing cells form a lump (tumour). What causes this is unclear.

You may be more likely to develop a salivary gland tumour if you:

• Are male
• Are over 55 years of age
• Smoke or drink alcohol
• Have had radiation therapy on your head and neck
• Have been exposed to certain substances in the workplace such as those found in rubber manufacturing, asbestos mining, and plumbing

At your first consultation, you will be seen by a doctor specialising in conditions affecting the head and neck, for example a consultant head and neck surgeon or a consultant maxillofacial surgeon.

Your consultant will ask you about your symptoms, general health, and medical history. They will perform a physical examination and feel your jaw, neck and throat for any lumps or swelling.

They may order tests and scans including:

• Imaging tests such as CT scans, MRI scans, ultrasound scans or X-rays
• A biopsy, which is where a small sample of cells from the lump is removed with a needle and syringe and sent to the laboratory to be examined for cancer cells

Your consultant will make a diagnosis based on your symptoms, physical examination and the results of your tests and scans. The only way to definitively diagnose salivary gland cancer is with a biopsy.

At Circle Health Group, your first appointment is where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have.

After making a diagnosis, your consultant will discuss possible treatment options with you and decide on the best option based on your symptoms and diagnosis.

Salivary gland lumps are normally removed with surgery. If your salivary gland tumour is benign, removal is still recommended as it can become large and unsightly or may become infected or cancerous.

Your consultant may remove all or part of your salivary gland.

• Partial removal of the salivary gland - If your salivary gland tumour is small and easy to access, your consultant may remove the lump and some of the surrounding tissue
• Removal of the entire salivary gland - if your tumour is large, difficult to access, or has spread to nearby structures, your consultant will remove the entire salivary gland and surrounding tissues and structures

There are various types of surgery to remove salivary gland tumours, and in addition you may need further surgery such as removal of lymph nodes or reconstructive surgery.

Parotidectomy

The most common type of salivary gland tumour occurs in the parotid salivary gland. During a parotidectomy, your consultant makes an incision in front of your ear that may extend to your neck. A parotidectomy can be superficial (partial) where only the lump and surrounding tissues are removed, or total where the entire parotid gland is removed.

Submandibular or sublingual gland surgery

If your tumour is in the submandibular or sublingual salivary gland, your consultant will remove the entire gland. A major facial nerve that controls the tongue including sensation and taste and the lower half of the face is located close to these glands and there is a risk that this nerve may be damaged during surgery.

If your tumour is cancerous, your consultant may need to remove some of the surrounding tissue, bones, and nerves. If your facial nerve needs to be removed during your surgery, your consultant will discuss this with you before your operation.

Minor salivary gland surgery

Minor salivary gland tumours can occur in the mouth, lips, tongue, roof of the mouth, nose, voice box, throat, and sinuses. Depending on the size and location of the tumour, your consultant will remove the salivary gland and some of the surrounding tissue.

Removal of lymph nodes

If your tumour is cancerous and there is a risk that the cancer has spread to your lymph nodes, your consultant may remove them.

Reconstructive surgery

If bone, skin, tissue, or nerves were removed during your surgery, you may need reconstructive surgery to rebuild and repair the area. Reconstructive surgery aims to restore your appearance as well as to improve function and your ability to speak, chew, swallow, and move your face.

Non-surgical treatments for lumps in the salivary gland

If your salivary gland tumour is found to be cancerous, you may need additional treatments such as chemotherapy and radiotherapy.

Chemotherapy

Chemotherapy involves giving powerful drugs to destroy cancer cells. You may receive chemotherapy if your cancer has spread from your salivary glands to other parts of your body.

Radiotherapy

During radiotherapy, a machine directs radiation towards the affected part of your body to destroy cancer cells.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication you are taking, including over-the-counter medicines.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

There are several different surgeries to remove salivary gland tumours. The type of surgery you will have depends on the size of your tumour, where it is located and whether or not the cancer has spread. Talk to your consultant about what will happen during your surgery.

Surgery to remove a salivary gland tumour is carried out under general anaesthetic, meaning you'll be asleep for the procedure.

Once the anaesthetic has taken effect, your consultant will make an incision (cut) close to where the tumour is located. The tumour, surrounding tissue and in some cases, nearby structures will be removed.

The incision is closed, and in some cases, a sterile dressing is applied.

The tumour will be sent to the laboratory for analysis. This will help your consultant decide whether any further treatment is necessary.

Most salivary gland removal surgery takes between one and two hours.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your surgery, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room.

When you wake up from your surgery, you will have a drain (a plastic tube connected to a collection vessel) in place to prevent blood from collecting under the skin. This will be removed before you go home.

You may have some pain after your salivary gland removal. Your healthcare team will give you medication to manage any post-operative pain.

How many nights will I need to stay in hospital?

You will normally need to spend one night in hospital after your surgery.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your salivary gland tumour removal or for twenty-four hours following a general anaesthetic. Please arrange for someone to come and collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on how quickly you recover from the surgery and the type of job you do. Most people return to work between a week and two weeks after surgery.

How soon can I drive?

You can drive when you can turn your head comfortably, safely control your vehicle and perform an emergency stop. Check with your consultant and inform your insurance company before driving after your surgery.

When will I be back to normal?

Recovery from salivary gland tumour removal is a gradual process that is different for everyone.

You may feel more tired than usual for a week or two after your surgery. It's important to go at your own pace during your recovery and stop if you have pain or feel tired. Follow your consultant's instructions carefully during your recovery and call the hospital if you have any questions or concerns.

You may experience facial weakness and numbness after your surgery. This normally improves within a few weeks.

Most people resume normal activities within two weeks of salivary gland removal surgery.

As with all types of surgery, salivary gland lump removal carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision, so please ask any questions you may have.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to salivary gland tumour removal include:

• Nerve damage
• Numbness of the earlobe
• Difficulty closing one eye
• Difficulty moving the lower lip
• Weakness of the facial muscles causing facial drooping
• Frey's syndrome - facial sweating at mealtimes
• Loss of sensation and numbness of the tongue
• Salivary fistula - an opening between the skin and the salivary gland
• Psychological effects - facial surgery can affect the way you look and make it more difficult to perform activities like speaking, eating, drinking, and smiling. These changes are often temporary but can affect your mood and self-esteem

Talk to your healthcare provider if you are having difficulty coping after your salivary gland removal surgery.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about salivary gland lump removal, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in April 2023. Next review due April 2026.

1. Salivary gland tumors, Mayo Clinic
2. Salivary Gland Cancer, John Hopkins
3. Salivary gland cancer, Macmillan Cancer Support
4. Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines, PubMed