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Salivary gland excision
Get expert treatment for salivary gland problems.
What is salivary gland excision?
The salivary glands are glands in your mouth that produce saliva and keep your mouth moist, allowing you to speak, eat and swallow as well as protecting your teeth from the bacteria that can cause tooth decay, and starting the process of digesting food.
There are three main types of salivary glands:
- Sublingual salivary glands
- Submandibular salivary glands
- Parotid salivary glands
Sometimes, your salivary glands may need to be removed because of an infection, blockage or salivary gland tumour. Removal of your salivary glands is known as salivary gland excision.
After salivary gland excision, your remaining salivary glands usually produce enough saliva to keep your mouth moist and the procedure rarely causes your mouth to become dry.
This page explains what salivary gland excision is, what happens during the procedure and what to expect during your recovery.
How much does salivary gland excision cost?
The cost of salivary gland excision depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you.
Why might I need salivary gland excision?
Your consultant may recommend salivary gland excision if you have a problem with your salivary glands such as a blockage, inflammation, infection or a tumour.
Salivary stones (sialolithiasis)
This is a condition where calcium stones (calculi) develop in your salivary glands, blocking the flow of saliva.
Salivary gland inflammation (sialadenitis)
Your salivary glands can become swollen (inflamed) due to salivary gland stones (sialolithiasis), certain autoimmune disorders such as Sjögren’s syndrome or infections with a virus or bacteria.
Infections can often be treated with a course of antibiotics, but if you keep getting infections, your consultant may recommend surgery.
Excessive salivation (sialorrhea)
Salivary gland excision may also be recommended to control a condition called sialorrhea where you produce too much saliva. It is also known as hypersalivation or drooling. Sialorrhea can affect people with conditions that affect muscle control in the mouth and face such as cerebral palsy, stroke or Parkinson’s disease. Salivary gland excision may be considered when other treatments such as medication haven’t worked.
Salivary gland tumours
Salivary gland tumours are growths of abnormal cells that develop in your salivary glands or the ducts that drain saliva from the salivary gland to your mouth. Most salivary gland tumours are benign (non-cancerous) but need to be removed and sent to the laboratory for analysis.
What to expect at your initial consultation
At your first consultation, you will be seen by a consultant head and neck, ear, nose and throat (ENT), or oral maxillofacial surgeon, a doctor specialising in operations involving the head, neck and mouth.
Your consultant will ask you about your symptoms, general health and medical history. They will perform a physical examination including a thorough examination of your face, neck, jaw and mouth to check for any abnormalities. They will also check the symmetry of your face and how well your facial nerves function.
Will I need any tests or scans?
Depending on your symptoms, your consultant may order some tests or scans to confirm or rule out a diagnosis and to check for any underlying health problems.
These may include:
- Blood tests — to provide information on your general health and identify certain medical conditions
- Imaging tests such as an X-ray, CT, MRI or ultrasound — provide detailed pictures of your salivary glands and the surrounding structures
- Biopsy —a small sample of cells is taken and sent to the laboratory for analysis to check for cancer cells
- Sialendoscopy — a small tube with a camera at the end (micro-endoscope) is used to check for blockages in your salivary ducts (the openings of your salivary glands)
How is a diagnosis made?
Your consultant will make a diagnosis based on your symptoms, physical examination and the results of any tests or scans.
Why is this first consultation so important?
At Circle Health Group, your first appointment is very important as it’s where you first meet your consultant, the doctor responsible for your care. Your consultant will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible during your treatment, so please discuss any questions or concerns with your consultant during your appointment.
At the end of your appointment, your consultant will decide if salivary gland excision is a suitable treatment for you based on your diagnosis, general health and expectations for treatment. They will explain the procedure in full, including how to prepare for your surgery, what happens during the procedure, any possible risks or complications, and what to expect during your recovery.
How to prepare for salivary gland excision
Your consultant will tell you everything you need to do to prepare for your salivary gland excision surgery. Instructions will also be in your appointment letter.
If there’s anything you’re not sure about, or if you have any questions about how to prepare for your procedure, 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, including over-the-counter medicines and supplements you are taking.
Your consultant may tell you to stop taking some medications like blood thinners for a few days before and after your salivary gland excision surgery. This is to reduce the risk of bleeding during and after your procedure.
If you have a beard, you may be asked to shave it off a few days before your surgery. Do not shave on the day of, or the day before your surgery, as this could lead to infections.
Take a shower with antibacterial soap the night before the procedure.
You will not be able to eat or drink anything from midnight on the day of your surgery.
What happens during salivary gland excision
Salivary gland excision is performed under general anaesthetic meaning you’ll be asleep for the procedure and won’t feel any pain.
There are several types of salivary gland excision surgery, depending on which gland is being removed.
Parotidectomy
A parotidectomy is the surgical removal of all or part of your parotid gland. It may be performed to remove a benign or cancerous tumour, or if you have salivary gland stones or an infection in your parotid gland.
During a parotidectomy:
- Once the anaesthetic has taken effect, your consultant will make a long excision (cut) from in front of your ear to the upper part of your neck
- They will lift your facial skin and locate your parotid gland
- Your consultant will carefully remove all or part of your parotid gland and any affected lymph nodes, taking care to avoid damage to your facial nerves
- At the end of the operation, a small tube may be placed through the skin into the underlying wound to drain any blood or fluid that may accumulate after your surgery
- Your incision will be stitched closed
How long will the operation take?
A parotidectomy normally takes between three and four hours.
Submandibular gland excision
Your submandibular glands are located just below your jaw. Your consultant may remove your submandibular gland to treat an infection or blocked salivary ducts, or to remove a tumour.
During submandibular gland excision:
- After the anaesthetic has taken effect, your consultant will make an incision of around 2-3 cm under your jawline
- Your consultant will carefully remove the submandibular gland and possibly some of the surrounding tissue
- The excision is closed with stitches
How long will the operation take?
Submandibular gland excision normally takes between 45 minutes and an hour and a half.
Sublingual gland excision
Sublingual gland excision is performed through your mouth to remove your sublingual gland — an almond-sized gland that lies in your mouth under the tongue. It is commonly used to remove a cyst called a ranula that may develop when the salivary ducts become blocked.
During sublingual gland excision:
- Once the anaesthetic has taken effect, your consultant will make a 2-3 cm long incision under your tongue
- Taking care to avoid damage to the nearby nerves, your consultant will locate and remove the entire sublingual gland before closing the incision with dissolvable stitches. If the remaining gap is large, a skin graft may be required.
How long will the operation take?
Sublingual gland excision normally takes around 30 minutes.
Surgery of the minor salivary glands
In addition to the three main pairs of salivary glands, there are 600 to 1000 minor salivary glands in various locations in your body. Cancer can develop in any of these glands including in your lips, tongue, inner cheek, the roof of your mouth (palate), voice box (larynx), throat, nose, or sinuses. What happens during minor salivary gland surgery depends on the type, location and size of the cancer, but involves making an incision in the area where the gland is located, and removing the tumour, surrounding soft tissue and any affected bone.
Recovering from salivary gland excision
After your salivary gland excision, you will be taken to the recovery room where you will be monitored closely until the anaesthetic has worn off. You will then be transferred to your room.
When you wake up, you may have a drain in place to drain any blood or fluid from your wound. This is normally removed the next day.
You may have some mild pain, swelling and bruising after your procedure which will resolve gradually over the next week or so. Your healthcare team will give you medication to help manage any pain or discomfort.
Sleeping with your head elevated on two or three pillows for the first four to five days after your surgery will help reduce any swelling.
Your consultant may test your facial nerves by asking you to make certain facial expressions after your salivary gland excision. This is to assess whether there was any damage to your facial nerves during your surgery.
Your consultant will give you instructions on how to care for your surgical wound after you are discharged. You can wash your wound gently with mild soap and water and pat dry with a clean towel.
Keep your wound clean and dry and take care when washing or shaving.
You may be prescribed a course of antibiotics to treat or prevent any infection after your salivary gland surgery.
If you do not have dissolvable stitches, you may be given an appointment to have your stitches removed around a week after surgery.
You should avoid strenuous activity and heavy lifting for around a week after your surgery. Light exercise such as gentle walking is beneficial during your recovery. Gradually increase the amount you walk every day.
How many nights will I need to stay in hospital?
You’ll normally need to spend one night in hospital after salivary gland excision surgery.
Will I be able to drive home?
You will not be able to drive yourself home from the hospital after salivary gland excision surgery. Please arrange for someone to collect you or we can organise a taxi if you prefer.
How soon can I go back to work?
You can expect to take around a week off work to recover after your salivary gland surgery. This may be longer if you have a very active job or one that involves strenuous activity or heavy lifting. Talk to your consultant about when you can expect to go back to work after your surgery.
How soon can I drive?
You can drive when you can safely control your vehicle and perform an emergency stop. Do not drive for at least 24 hours after having a general anaesthetic, or while taking any medication, such as strong painkillers, that could affect your concentration or impair your reaction times.
When will I be back to normal?
Recovery from any type of surgery is different for everyone and depends on your age, general health, the type of surgery you had and your individual recovery.
You can help your recovery to go more smoothly by resting at home for at least a week after your procedure and allowing your body to recover at its own pace. Follow your consultant’s post-operative instructions carefully and call the hospital if you have any questions or concerns.
You will be given a follow-up appointment to check your progress and get your biopsy results (if you had one) around two to six weeks after your surgery.
Most people can return to normal daily activities within a few weeks of salivary gland excision surgery.
Potential risks and complications of salivary gland excision
As with any type of surgery, salivary gland excision carries a small risk of complications. Your consultant will explain any possible risks and complications before your surgery and answer any questions you may have.
We want you to be as well-informed as possible about any potential risks and complications as this will help put your mind at rest about your surgery and allow you to make an informed decision.
Possible complications of any surgery include:
- Bleeding
- Wound infection
- Chest infection
- Blood clots
- Adverse reactions to the anaesthetic
In addition to the above, possible complications of salivary gland excision include:
Nerve damage
There are several nerves in your face (your facial nerves) that control sensation and movement. These may be affected either by the tumour or by damage during surgery. Nerve damage is usually temporary, but in some cases may be permanent. The symptoms of facial nerve damage depend on the nerves affected and the type of salivary gland excision you had.
Symptoms of nerve damage may include:
- Numbness around your surgical wound
- Numbness around your earlobe
- Facial weakness and drooping on the side of your surgery
- Difficulty moving your lower lip
- Numbness and loss of sensation in your tongue
- Problems closing your eye
Other possible complications of salivary gland excision include:
Scarring
During your surgery, your consultant will use techniques to try to make your scars less visible, but you may still have some scarring after your surgery. Most scars fade over time.
Seroma
This is a build-up of fluid under the skin around the surgical site. It usually goes away on its own, but in some cases, may need to be drained.
Salivary fistula (sialoceles)
A salivary fistula is a hole that develops between your salivary gland and your skin. Most heal by themselves in a few weeks, but some may require treatment such as medication, oxygen therapy, or surgery.
Fray’s syndrome
Fray’s syndrome occurs when the nerves that control saliva production join with the nerves that control sweating, causing facial sweating and flushing while eating. It normally occurs on the side of your face where you had surgery and can happen months or even years after salivary gland excision. Fray’s syndrome doesn’t usually need treatment, but if your symptoms are severe, treatment may include botulism toxin injections (Botox) or topical medications (medications applied to the skin).
Swallowing difficulties
Some types of salivary gland excision surgery can cause changes to the way you chew and swallow. If this is the case, we can refer you to a speech and language therapist to assess your swallowing and teach you exercises to help make swallowing easier.
Why choose Circle Health Group for salivary gland excision?
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 excision treatment, book your appointment online today or call a member of our team directly on 0808 189 5499.
Clinical review and sources
- Submandibular Gland Excision Johns Hopkins
- Submandibular gland excision - Surgery for infection and/or recurrent blockage ENTUK
- Submandibular excision National Library of Medicine
- Removal of Submandibular Gland Hull University Teaching Hospitals NHS Trust
