The human body has three pairs of major salivary glands and thousands of minor salivary glands located in the lips, cheeks and palate. The major salivary glands are parotid gland located below the ear, submandibular and sublingual gland located in the floor of the mouth and neck. All these glands can get affected by inflammatory diseases or neoplasms (tumors).
The minor salivary glands in the lip and cheek most commonly develop a swelling after an accidental lip or cheek bite. It is called a mucocele or mucous retention cyst. They are usually painless and may sometimes burst spontaneously if injured. However, more often than not they will reccur. They are treated by surgical excision in totality with neighbouring glands. If not done well they have a chance to recur.
The major salivary glands can get affected by obstructive diseases ( salivary gland stones or sialolithiasis) or by tumors affecting these major glands. Most commonly, the submandibular gland gets affected by salivary stones which if in the duct can be removed by a minor surgery. If the stone forms in the gland or in the deeper part of the duct, the treatment of choice is gland excision. These patients present with pain and swelling in the neck associated with timing of food intake.
The tumors that affect the salivary glands mostly affect the parotid gland and cause a swelling in the area below the ear. They are most frequently benign. For management of tumors, the gland is excised depending on the size of the tumor. In the parotid gland, care should be taken to avoid damage to the facial nerve, external carotid artery. It needs extreme caution, patience and skill to do this surgery.
Dr Nisheet Agni also has a book published by Jaypee Publications titled: “ Salivary Gland Pathology.
The submandibular gland excision is simpler as compared to the parotid. Here, only the marginal mandibular nerve needs to be taken care of. If not the patient might develop a drooping most on the same side.