Salivary gland conditions
The salivary glands produce saliva, which keeps the mouth moist, helps with swallowing and digestion, and contributes to oral health.
Problems affecting the salivary glands include stones or narrowing of the salivary ducts, infection and inflammation, and benign or malignant tumours.
Where are the salivary glands?
There are three pairs of major salivary glands.
The parotid glands are located in front of and below the ears. The submandibular glands lie beneath the lower jaw, and the sublingual glands are located beneath the tongue.
There are also many smaller salivary glands throughout the mouth and throat.
Salivary stones and duct obstruction
Saliva travels from each major gland into the mouth through a duct. A stone or narrowing of the duct can obstruct the flow of saliva.
A typical symptom is pain or swelling of the gland that becomes more noticeable around mealtimes, when saliva production increases.
Repeated obstruction can result in recurrent inflammation or infection of the gland.
Salivary gland infection and inflammation
Salivary glands can become inflamed or infected.
Acute infection may cause painful swelling, tenderness, fever and sometimes discharge of pus from the opening of the salivary duct.
Recurrent swelling may be associated with a stone or narrowing of the duct, reduced saliva production or an underlying inflammatory condition.
Salivary gland lumps
A persistent lump can develop within a salivary gland, most commonly the parotid gland.
Many salivary gland tumours are benign, particularly within the parotid gland, but examination alone cannot reliably establish the diagnosis.
A persistent or enlarging salivary gland lump should therefore be assessed.
H2: When should a salivary gland lump be assessed promptly?
Features that may warrant timely assessment include:
• A persistent or enlarging lump
• Significant or persistent pain
• Facial weakness or a change in facial movement
• Numbness of the face
• A firm or fixed mass
• Enlarged lymph nodes in the neck
These features do not necessarily indicate cancer, but further investigation may be appropriate.
H2: How are salivary gland conditions assessed?
Assessment begins with the pattern of symptoms and examination of the gland, mouth and neck.
Depending on the problem, investigation may include ultrasound, CT or MRI.
Ultrasound
Ultrasound can assess superficial salivary gland abnormalities and may identify a stone, inflammation or a mass. It can also be used to guide needle sampling.
Fine-needle aspiration or core biopsy
When a salivary gland mass is identified, cells or tissue may be sampled using fine-needle aspiration or core biopsy.
The biopsy result is interpreted together with the examination and imaging findings.
How are salivary gland conditions treated?
Treatment depends on the underlying problem.
Infection and inflammation may require treatment of contributing factors and, when appropriate, medication. Management of duct obstruction depends on the location and nature of the obstruction.
Some salivary gland tumours require surgical removal.
Salivary gland surgery
The type of surgery depends on which gland is involved and the diagnosis.
The facial nerve passes through the parotid gland and controls movement of the muscles of the face. Preserving facial nerve function is therefore an important consideration during parotid surgery.
Surgery involving the submandibular gland also requires consideration of nearby nerves involved in movement and sensation of the tongue and movement of the lower lip.
The specific benefits and risks of an operation depend on the condition and the procedure being considered.
Salivary gland care at Hawthorn ENT
Dr Depak Patel is an ENT and head and neck surgeon with advanced fellowship training in head and neck surgery.
His practice includes assessment and surgical management of salivary gland conditions, including persistent swelling, salivary gland lumps and tumours.
Investigation and treatment are tailored to the diagnosis and individual patient.
Appointments for salivary gland conditions
If you have recurrent salivary gland swelling, meal-related pain or a persistent lump in the parotid or submandibular region, specialist assessment can help establish the cause and determine whether further investigation or treatment is required.