Besides very many small salivary glands, which lie in the mouth, there are four more, which are located outside the mouth. Most of the salivary flow is increased by the four salivary glands, which therefore lie outside the mouth. Under both jaw edges is a gland (gland) submandibularis (lower jaw). On both sides of the ear is a major salivary gland, Parotid gland (the ear). The latter salivary gland consists of two parts: one part operation and a deep part. Between these two parts into one goes very important nerve, the sciatic (nerve) facial (face). This will include nerve to close the lips and raising the mouth (laugh) and closing of the eyelids.

Through a thin tube, the salivary glands into the mouth from this place. Saliva moistens food and taken by chewing the enzymes (substances needed for digestion) from the saliva of the mixed food. This is the first step in the digestive process.

In the salivary gland tumors or inflammation may occur. The drains into the mouth may prevent stones that impede the drainage and can lead to inflammation. Salivary glands are very dependent on adequate moisture in the body. You experience a shortage of moisture quickly by the appearance of a dry mouth.

What are the symptoms of salivary gland disorders?

* Salivary Stones
If a saliva stone one of the drains will exit this pain because the saliva can’t flow into the mouth. This occurs when food and / or drink, especially with substances that stimulate saliva production much like sour candy, sour drinks and such. The bad arise in the course of days / weeks also inflammation. The pain is more constant presence. Sometimes this is characterized by pus drainage from the corridor into the mouth, which gives a bad taste.
* Drying
Even without problems with the drainage inflammation may occur, especially if prolonged salivary glands are not stimulated to issue saliva fluid. This is sometimes seen in elderly people with insufficient fluids.
* Tumor
The most common salivary gland swelling of the jaw is the swelling that occurs with the mumps.

A tumor in a salivary gland is noted by having a bulge in one of the jaw edges arises or at or near the cheek to the ear. Sometimes the major salivary glands stand out as the earlobe. In general, this gives no pain. It is usually a benign tumor, malignant tumors of the salivary glands are rare.

What research are possible?

* Physical examination
Both inflammation as a tumor in the physical examination by a physician properly established. Often a stone eventually present in a drain on the inside of the cheek be felt.
* Additional research
o Echo
This is a simple, painless examination with sound waves, which can be determined whether salivary stones and where those are. In case of a tumor can be seen against this tumor of the salivary gland lies.
o Puncture
With a needle from the tissue is a very small monster taken, viewed under the microscope. Usually this can already be determined for any swelling to go.
o Sialografie
When there is doubt as to the diagnosis in one case an indication (= reason) to make This is an X-ray, in contrast with the current is injected salivary gland.
o-CT scan (computer tomography examination)
Here are the X-rays made with a computer to a special image converted. In some cases this method is desirable to obtain further details.
o MRI scan
These are similar pictures as in a CT-scan. However, no X-rays used. Moreover, this technique lends itself better known as “soft tissue” to display.

What are the treatment options?
Sometimes sucking on candy or citric acid flush with the salivary glands further promoted so stones or inflammation can be exorcised. Surgery is necessary if this fails, an infection with antibiotic treatments do not achieve the desired results or if there is a tumor.

The operation
Through the day-care or a short recording, the operation performed. There is no special preparation needed.

Mandibular salivary gland
Through a small incision (5 cm) along the bottom edge jaw, the entire gland removed in its drainage corridor. Just past this is a gland gevoelszenuwtak the mandible. In one case, the feeling after the surgery which temporarily reduced.

Major salivary gland

The incision for this operation goes on past the ear straight down, bend down below the earlobe back and goes under the jaw edge is 5 cm by. This section provides the finest cosmetic result.

Superficial parotidectomie

Superficial parotidectomie is a removal of the superficial part of the gland. This is the most common operation, which is done when there is a benign tumor or a chronic inflammation problem. It is the superficial part of the gland cleared of all branches of the facial nerve, and completely removed. This is very tricky task, because the small nerve branches and to remove tissue directly against the abut. There is often a drain (tube) left, so no blood can accumulate under the skin.

Total parotidectomie
Parotidectomie is a total removal of the entire gland. Usually this operation is performed in connection with a malignant tumor.

Possible complications of operative treatment

No surgery is free from the risk of complications. There are also operations on salivary glands of the normal risks of complications of surgery such as bleeding, wound infection.

There are also specific possible complications, such as:

Nerve Damage
Particularly in the large salivary gland the risk of damage to one or more of the branches of the facial nerve. Generally creates a temporary (usually partial) failure of one or more facial muscles. It may be that the eyelid does not close properly and / or the mouth is. If the eyelid is not functioning properly, this night with a tape should be kept closed, because otherwise damage the cornea. When failure of foot muscles is especially drinking difficult, because the lips on one side is not functioning properly. By (smile) remains the laughing mouth hanging. It is almost always happy for a temporary failure, the nerve branch is rarely cut. If the latter is done, then you by your surgeon after surgery told.

In the case of a full salivary gland removal in connection with a malignant tumor is often necessary nerve (partly) remove! Sometimes it may have been attached, in other cases, possibly in a later stage an attempt to recover operation.

In many cases reduces (sometimes temporary) feeling in the ear lobe.

Frey syndrome
This syndrome is sometimes, usually some time after surgery. During or after dinner there will be sweating in the area of the ear. The cause of this phenomenon is not clear. The phenomenon is sometimes a nuisance but it can’t hurt. There are creams that can sometimes help, but unfortunately there is not always a satisfactory treatment possible.

After surgery
The day after the operation, Depending on the operation you can first to third day home. Against the pain is usually a simple enough painkiller (eg paracetamol). The day after surgery you may shower again and once home, there are no specific rules. You get an appointment for outpatient monitoring.

If nerves are not fully functioning more than a long time (sometimes six months) before the restoration is complete. The loss of one or two major salivary glands appears to pose no problems.
The most common benign tumor, the tumor blended, tends to return (relapse). This is why, after such an operation is usually at least one years tumor remains under control.
Where problems occur when you get home, then please contact your doctor or your treating specialist.
Any questions?
This brochure is not intended to replace verbal information, but to complement it. This makes it possible to have all the comfort of home to read.
Any questions, please contact your hospital outpatient surgery.