Salivary Glands Surgery

Problems of the parotid, submandibular, or sublingual glands can cause swelling, pain, infections, stones, or tumors. My approach is diagnosis-first and nerve-sparing: we confirm the cause with targeted imaging, favour minimally invasive options when possible, and perform precise surgery with facial-nerve protection and meticulous closure.

What I treat

Salivary stones (sialolithiasis) — recurrent swelling/pain with meals, infections
Chronic sialadenitis / obstructive duct disease
Benign tumors (e.g., pleomorphic adenoma, Warthin tumour)
Ranula / mucous cysts of the floor of mouth
Post-infectious or post-traumatic duct strictures

When is surgery recommended?

Recurrent painful swelling or infections from stones/strictures
Enlarging mass or imaging features suggestive of a tumour
Failure of conservative care (hydration, sialogogues, gland massage, antibiotics)
Uncertain diagnosis where tissue analysis is required

Most patients maintain normal saliva after treatment—the remaining glands compensate.

Techniques (minimally invasive first)

All specimens are sent for histopathology; oncology care is coordinated promptly if required.

Parotid Surgery (Nerve-Sparing Parotidectomy)

Indications: tumours, complex stones, recurrent infection.
Approach: discreet incision along natural creases; facial-nerve identification/monitoring; superficial or total conservative parotidectomy, or selective extracapsular dissection for small, well-placed benign lesions.
Scar & sensation: ear-lobe numbness is common early and often improves.
Frey’s syndrome (gustatory sweating) prevention: barrier techniques (e.g., SMAS/fascia interposition) when indicated.

Sialendoscopy (Endoscopic Stone & Duct Treatment)

What it is: a miniature endoscope passed through the natural duct opening to visualise and treat stones/strictures.
What we do: dilation, basket retrieval, gentle fragmentation; combined approach with a tiny skin or intraoral incision when stones are large/impacted; duct repair and, when needed, a temporary stent.
Benefits: gland-preserving, minimal scars, quick recovery.

Transoral Stone Removal (Submandibular / Sublingual)

For stones near the duct opening or in the floor of mouth.
Small intraoral incision, stone removal, ductal repair, no external scar.
Can be paired with sialendoscopy for precise localisation.

Submandibular Gland Excision

Indications: deep/proximal stones not amenable to endoscopy, recurrent infection, or tumours.
Approach: short incision under the jawline; protection of marginal mandibular, lingual, and hypoglossal nerves; meticulous haemostasis.

Sublingual Gland (Ranula / Plunging Ranula)

Preferred treatment: transoral excision of the sublingual gland ± cyst management to reduce recurrence; careful protection of the lingual nerve and Wharton’s duct.

The procedure, step by step

1. Anaesthesia (general for most open procedures; local or light GA for sialendoscopy)
2. Planned incision / endoscopic entry and nerve-sparing dissection
3. Stone removal / tumour excision with clear margins when needed
4. Duct repair or stenting if indicated; drain for open cases (typically 24–48 h)
5. Layered closure and scar care protocol; written aftercare

Hospital stay: same-day for sialendoscopy and many transoral cases; 1 night (occasionally 2) for parotid/submandibular surgery.

Recovery & aftercare (typical)

Swelling/bruising: 3–10 days depending on procedure; cool packs help
Diet: soft foods and good hydration early on; sour sweets (if advised) to stimulate flow after duct work
Drains: usually removed 24–48 h
Stitches: removed 5–7 days for skin; intraoral sutures often dissolvable
Activity: light activity within days; avoid pressure/straining on the area for ~2 weeks
Scar care: SPF 50+ for 12 months; silicone gel/taping once healed

Safety & risks (discussed in consent)

Temporary weakness of a facial-nerve branch (parotid) or lower-lip asymmetry (marginal mandibular) — usually improves
Ear-lobe numbness, altered taste or tongue sensation (rare; lingual nerve proximity)
Haematoma, infection, salivary leak/sialocele, seroma; rare long-term dry mouth
Frey’s syndrome (gustatory sweating) — barrier techniques reduce risk; treatable if it occurs
Stone/tumour recurrence (uncommon with complete treatment)
Oncologic findings may require additional surgery or adjuvant care

You receive clear instructions, direct contact pathways, and scheduled reviews.

FAQs

Will I have a visible scar?

Sialendoscopy and many stone removals are scar-free. Parotid/submandibular surgery uses discreet creases under the jawline or around the ear.

Will I have dry mouth after gland removal?

Typically no. Remaining glands compensate. We discuss saliva-support strategies if you’re at higher risk.

Can stones come back?

Recurrence is possible but less likely after full removal and duct optimisation. Hydration and salivary health tips are provided.

Is the facial nerve at risk in parotid surgery?

We use nerve-sparing technique and monitoring. Temporary weakness can occur and usually resolves; permanent deficit is rare.

Do all masses go to the lab?

Yes. Histopathology is routine to confirm diagnosis and margins.