Salivary gland removal surgery is considered a delicate procedure that some patients may need when persistent problems occur, such as recurrent infections, chronic stones, or the presence of tumors inside the gland. Although the idea of surgery may cause anxiety for some people, in many cases it is the best solution to relieve pain, prevent complications, and improve quality of life.In this Dalili Medical article, we will explore the main reasons for performing salivary gland removal surgery, the symptoms that may lead a doctor to recommend it, the recovery period, and whether the procedure is generally considered safe or risky in most cases.

What Is Salivary Gland Removal (Salivary Gland Excision)?

Salivary gland removal is a surgical procedure in which one or more salivary glands are removed, such as the parotid gland, the submandibular gland, or the sublingual gland. It is commonly performed to treat conditions such as tumors, chronic stones, or persistent infections that do not respond to medication.

Is Salivary Gland Removal Surgery Dangerous?

In most cases, salivary gland removal is considered a safe procedure when performed by an experienced surgeon. However, like any surgery, it may be associated with certain risks and complications, which vary depending on the type of gland removed and the patient’s overall health condition.

Does Salivary Gland Removal Cause Dry Mouth?

Not necessarily. Other salivary glands can usually compensate by producing enough saliva. However, some patients may experience varying degrees of dry mouth after surgery.

How Long Does Salivary Gland Surgery Take?

The duration of the operation varies depending on the type of gland being removed and the complexity of the case. It differs from patient to patient based on surgical circumstances.

Is General Anesthesia Required?

In most cases, the procedure is performed under general anesthesia, especially in traditional surgeries. The type of anesthesia is determined by the surgeon based on the patient’s condition.

When Can You Eat After Surgery?

This depends on the type of surgery and recovery progress. Patients usually start with fluids and soft foods gradually according to the doctor’s instructions.

When Can I Return to Normal Life?

Recovery time varies from one patient to another depending on the type of surgery and healing response. Most patients return to normal activities gradually over a period determined by their doctor.

Can the Problem Return After Gland Removal?

This depends on the underlying cause of the surgery. In many cases, the treatment is definitive, but in some situations, recurrence depends on the nature of the original disease.

Can Parotid Gland Removal Affect Facial Nerves?

Yes, in some cases. The parotid gland is located near the facial nerve, which controls facial movements. Surgeons take great care to avoid nerve damage, but temporary or, in rare cases, permanent effects may occur depending on the complexity of the surgery.

Does Submandibular Gland Removal Affect Speech or Swallowing?

Some temporary symptoms may occur in limited cases, such as mild difficulty swallowing or a feeling of tightness. These symptoms usually improve over time depending on the individual case and healing process.

Does the Surgery Leave a Scar?

Yes, it may leave a surgical scar, especially in open surgeries. However, the scar usually fades over time and becomes less noticeable. Modern surgical techniques also help minimize scarring as much as possible.

When Should You Contact a Doctor After Surgery?

You should contact your doctor immediately if you experience:

• Unusual bleeding
• Severe or increasing swelling
• High fever
• Difficulty swallowing or breathing
• Severe pain that is not controlled
• Any unusual or concerning symptoms

Does Salivary Gland Removal Affect Speech?

In most cases, it does not cause permanent speech problems. Some patients may experience mild temporary difficulty during early recovery, but speech usually returns to normal gradually.

Can You Live Normally After Salivary Gland Removal?

Yes. Most patients return to a normal life after surgery, as the remaining salivary glands typically compensate and maintain sufficient saliva production.

Is Salivary Gland Surgery Painful?

Postoperative pain is usually mild to moderate and can be controlled with prescribed medications. Pain gradually decreases and disappears during the recovery period.

Can Salivary Gland Removal Be Done Without Open Surgery?

In some selected cases, less invasive techniques such as endoscopic surgery or modern minimally invasive approaches may be used. However, the choice depends on the patient’s condition, the type of problem, and the location of the affected gland.

Do All Salivary Gland Tumors Require Removal?

Not necessarily. The decision depends on several factors such as:

• Type of tumor
• Size
• Location
• Whether it is benign or malignant
• Overall patient health

Can Swelling Persist for Weeks After Surgery?

Yes, swelling may persist for some time after surgery. This is normal in many cases and gradually improves as healing progresses.

Does Salivary Gland Removal Affect Taste?

Some patients may experience temporary changes in taste after surgery, depending on the surgical area and nearby tissues. Taste usually returns to normal over time.

Can You Sleep on the Operated Side After Surgery?

This depends on the recovery stage and doctor’s instructions. In the early days, patients are usually advised to avoid pressure on the operated side to reduce pain and swelling.

Can You Exercise After Salivary Gland Removal?

Strenuous physical activity should be avoided for a period determined by the doctor. Patients can gradually return to exercise once healing is stable.

Can You Travel After Surgery?

Travel is possible after the initial recovery phase and once the condition is stable, but only after consulting the doctor to determine the appropriate timing.

Is a Surgical Drain (Drainage Tube) Sometimes Required?

In some cases, a small drainage tube (drain) may be placed after salivary gland surgery to remove excess fluid or blood from the surgical site. It helps reduce swelling and promote healing and is removed later by the doctor.

Is Pathology Analysis Important After Removal?

Yes, histopathological examination is very important, especially if a tumor was present. It helps:

• Determine whether the tumor is benign or malignant
• Assess the level of risk
• Decide if additional treatment (such as radiotherapy or follow-up) is needed
• Guide the future treatment plan

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Types of Salivary Gland Removal Surgeries

The type of surgery depends on the gland involved, the reason for surgery, and the extent of tissue removal.

1. Parotid Gland Removal

This can be done in several ways:

Superficial Parotidectomy:
Removal of the outer part of the gland, usually for benign tumors.

Total Parotidectomy:
Removal of the entire gland when necessary.

Radical Parotidectomy:
Used in advanced or complex cases and may include removal of surrounding tissues.

2. Submandibular Gland Removal

This procedure involves removing the submandibular gland. It may be:

• Complete removal of the gland
• Partial removal in selected cases

3. Sublingual Gland Removal

This involves removing the sublingual gland, and it is most commonly used in cases such as cysts or recurrent problems affecting the gland.

4. Minor Salivary Gland Removal

These are small glands distributed throughout the mouth. Some of them may be removed when needed to treat localized tumors or specific lesions.

5. Partial Removal (Partial Excision)

In this type, only part of the affected gland is removed while preserving as much healthy tissue as possible whenever feasible.

6. Total Removal (Complete Excision)

In this procedure, the entire gland is removed when the disease affects the whole gland or when medically necessary.

7. Surgical Techniques

Salivary gland removal can be performed using different approaches depending on the case:

• Traditional open surgery
• Endoscopic surgery in selected cases
• Robotic surgery in advanced medical centers

Causes of Salivary Gland Removal Surgery

Salivary gland removal is performed when medical or minimally invasive treatments fail. The goal is to treat the condition and prevent complications. The main causes include:

1. Salivary Gland Tumors

Tumors are one of the most common reasons for surgery, including:

• Benign tumors: such as pleomorphic adenoma, which usually requires removal to prevent growth or complications
• Malignant tumors (cancerous): which often require partial or total gland removal, sometimes with surrounding tissue depending on the case

These tumors may affect:

• Parotid gland
• Submandibular gland
• Sublingual gland

2. Salivary Gland Stones (Sialolithiasis)

Stones can form inside the salivary ducts, causing blockage and leading to:

• Severe pain, especially during eating
• Recurrent swelling of the gland
• Chronic infections
• Reduced saliva flow

If conservative treatment or endoscopic removal fails, surgery may be required.

3. Chronic or Recurrent Infections

Repeated infections can damage gland tissue over time, making surgical removal the final treatment option in some cases.

4. Abscesses or Severe Infections

In cases of deep abscess formation or severe infection that does not respond to antibiotics, surgery may become necessary.

5. Cysts or Salivary Cystic Lesions

Large or recurrent cysts may cause discomfort and may require partial or complete gland removal.

6. Autoimmune Diseases and Chronic Enlargement

Some autoimmune conditions affect salivary glands, such as:

• Sjögren’s syndrome
• Chronic autoimmune inflammation
• Persistent gland enlargement

In selected cases, surgery may be considered.

7. Trauma or Injury

Severe injuries or accidents may damage the salivary gland, making removal necessary in some situations.

Symptoms That May Lead to Salivary Gland Removal

Symptoms vary depending on the underlying cause, but there are warning signs that may indicate the need for surgical intervention, including:

Symptoms That May Indicate the Need for Salivary Gland Removal

1. Persistent or Recurrent Swelling of the Gland

Swelling in the gland area that does not completely disappear or keeps returning, especially if it is associated with pain or gradual increase in size.

2. Severe or Chronic Pain

Ongoing or recurrent pain, particularly during eating or saliva secretion, may indicate blockage or stones inside the gland.

3. Palpable Lump or Mass

Feeling a lump in areas such as the parotid gland or submandibular gland, especially if it is progressively increasing in size.

4. Recurrent Infections That Do Not Respond to Treatment

Repeated infections despite antibiotics and conservative treatment may indicate chronic gland damage that requires removal.

5. Pus or Abnormal Discharge

The presence of purulent discharge from the salivary duct or a persistent abnormal taste in the mouth may indicate severe chronic infection.

6. Difficulty Swallowing or Speaking

If gland enlargement compresses nearby structures, it may lead to noticeable difficulty in swallowing or speaking.

7. Numbness or Facial Muscle Weakness

Especially in parotid gland problems, this may suggest involvement of nearby nerves and requires urgent medical evaluation.

8. Severe Dry Mouth with Gland Dysfunction

In advanced cases, the gland may lose its function almost completely, leading to significant dry mouth.

9. Warning Signs of Possible Malignancy

These include:

• Rapid growth of a mass
• Persistent unexplained pain
• Unintentional weight loss
• Swelling of lymph nodes
• Changes in facial muscle movement

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Complications of Salivary Gland Removal Surgery

Complications are generally uncommon, especially when performed by an experienced surgeon. However, like any surgical procedure, some risks may occur depending on the gland involved and the patient’s condition.

1. Pain and Swelling After Surgery

Common expected symptoms include:

• Pain at the surgical site
• Swelling in the face or neck
• Tightness or stiffness around the incision

These symptoms usually improve gradually over time.

2. Bleeding or Hematoma

Minor bleeding or blood collection under the skin may occur and sometimes requires simple medical intervention or monitoring.

3. Infection

Signs of infection may include:

• Redness
• Local warmth
• Pus discharge
• Fever

4. Nerve Injury

One of the most important potential complications:

In parotid gland surgery:

• The facial nerve may be affected
• This can lead to temporary facial weakness
• In rare cases, it may be permanent

In submandibular gland surgery:

• Nearby nerves may be affected
• Possible symptoms include:
  • Tongue numbness
  • Temporary tongue weakness
  • Altered sensation in the jaw area

5. Saliva Leakage or Accumulation

In some cases, saliva may accumulate under the skin or leak from salivary ducts.

6. Dry Mouth

Some patients may experience varying degrees of dry mouth, especially if other glands cannot fully compensate.

7. Frey’s Syndrome

This may occur after parotid gland removal and includes:

• Sweating while eating
• Warmth or flushing in the cheek during meals

8. Surgical Scar

A scar may remain at the incision site, but it usually fades over time and becomes less noticeable.

9. Recurrence of the Original Problem (Rare)

In rare cases, the original condition may recur depending on the underlying disease (such as infections or certain medical conditions).

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How to Prepare for Salivary Gland Surgery

Proper preparation before surgery helps reduce complications and speeds up recovery.

1. Inform the Doctor About Medical History and Medications

Patients should inform their doctor about all medications, including:

• Blood thinners (e.g., aspirin)
• Pain relievers (e.g., ibuprofen)
• Supplements and herbal products (e.g., fish oil, ginkgo biloba)

Some of these may increase bleeding risk.

2. Stopping Certain Medications

The doctor may advise stopping blood-thinning medications several days or a week before surgery, depending on the case.

3. Avoid Smoking

Smoking negatively affects:

• Wound healing
• Recovery speed
• Overall surgical outcomes

It is recommended to stop smoking before surgery.

4. Fasting Before Surgery

Patients are usually asked to avoid eating and drinking for 6–8 hours before surgery to ensure safe anesthesia.

5. Preparing for Recovery

It is important to:

• Arrange for someone to assist after surgery
• Prepare a comfortable home recovery environment
• Be ready for the initial recovery period

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Surgical Techniques for Submandibular Gland Removal

There are several approaches used for removing the submandibular gland, and the surgeon selects the most appropriate method depending on the patient’s condition and diagnosis.

1. Open (Traditional) Surgery

This is the most commonly used technique and includes:

• Making an incision under the jaw
• Carefully accessing the salivary gland
• Separating the gland from surrounding tissues
• Preserving important nearby nerves
• Removing the gland completely if needed
• Closing the wound with stitches

2. Partial Excision

In some cases, only the affected part of the gland is removed instead of removing the entire gland, depending on the doctor’s evaluation.

3. Endoscopic Surgery

This is used in limited cases in specialized centers, especially for stone removal or minor interventions. It is less invasive and involves smaller incisions.

4. Gland Removal with Stone Extraction

If the problem is caused by salivary stones, the gland may be removed while extracting the stones during the same procedure.

5. Robot-Assisted Surgery

In advanced medical centers, robotic surgery may be used to improve precision and reduce scarring. However, it is not available in all hospitals.

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How Salivary Gland Surgery Is Usually Performed

Salivary gland removal is typically performed under general anesthesia. During the procedure, the surgeon aims to remove the affected gland while preserving nearby nerves and blood vessels as much as possible.

During surgery, the focus is on:

• Protecting the nerve responsible for tongue movement
• Preserving the nerve related to tongue sensation
• Avoiding injury to nerve branches near the jaw

The surgical approach depends on:

• The cause of removal (stones, tumor, chronic infection)
• Size and extent of the condition
• Presence of tumors or stones
• Function of the gland
• Surgeon’s experience and available technology

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After Salivary Gland Removal Surgery

Recovery after salivary gland removal occurs in stages and varies from patient to another depending on the type of gland and overall health condition.

First 24–48 Hours After Surgery

This is the initial monitoring phase and may include:

Pain and Swelling

• Mild to moderate pain at the surgical site
• Swelling in the jaw, face, or neck area
• A feeling of tightness or stiffness

Drain Tube (if used)

In some cases, a small drainage tube is placed to remove fluid or blood and is usually removed within 1–2 days.

Eating and Drinking

• Start with fluids
• Progress to soft foods gradually
• Avoid hard or very hot foods

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First Week After Surgery

Wound Care

• Keep the surgical site clean and dry
• Change dressings as instructed by the doctor
• Watch for redness or unusual discharge

Temporary Normal Symptoms

• Mild swelling
• Temporary numbness
• Slight difficulty in chewing or swallowing
• Gradually improving pain

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2 to 6 Weeks After Surgery

Gradual Improvement

• Noticeable reduction in swelling
• Progressive wound healing
• Scar appearance improves over time

Return to Normal Life

• Gradual return to daily activities
• Based on doctor’s advice and patient condition

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Possible Post-Surgery Effects (Usually Temporary)

After Parotid Gland Removal

• Temporary facial muscle weakness (in some cases)
• Frey’s syndrome (sweating while eating)

After Submandibular Gland Removal

• Temporary numbness in the tongue or mouth
• Mild temporary changes in tongue movement in some cases

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When Should You Contact a Doctor Immediately?

Seek medical attention if you experience:

• Severe bleeding
• Increasing swelling instead of improvement
• High fever
• Pus discharge
• Severe, unmanageable pain
• Difficulty breathing or swallowing
• Sudden facial muscle weakness

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Does the Surgery Cause Dry Mouth?

In most cases, severe dry mouth does not occur, because the remaining salivary glands usually compensate and produce enough saliva after removal of the affected gland.