Salivary Gland Removal — Procedure Guide, Recovery & Risks | MyMedicPlus

Salivary gland removal (sialoadenectomy) surgically excises a major salivary gland: the parotid (largest), submandibular, or sublingual gland. Parotidectomy is most common, performed as superficial (lateral to facial nerve) or total (deep and superficial lobes) depending on tumor location.

Indications include benign neoplasms (pleomorphic adenoma, Warthin tumor), malignant salivary gland tumors (mucoepidermoid, adenoid cystic carcinoma), recurrent parotitis, chronic sialolithiasis (stones) not amenable to lithotripsy or endoscopy, and salivary fistula.

Under general anaesthesia, a pre-auricular and cervical incision exposes the parotid gland. The facial nerve (CN VII) is identified at the stylomastoid foramen and traced forward; the superficial lobe is removed preserving all branches. Submandibular removal uses a 4 cm neck incision, protecting the marginal mandibular nerve and lingual nerve.

Hospital stay is 1-2 days; drains are removed within 24-48 hours. A soft diet is recommended for 2 weeks. Sutures are removed at 7-10 days. Swelling and stiffness improve over 2-3 weeks. Frey syndrome (gustatory sweating) may develop weeks to months post-operatively.

Temporary facial nerve weakness occurs in up to 20% of parotidectomy patients; permanent palsy is below 2% with careful nerve dissection. Frey syndrome (sweating while eating) affects 15-30% of patients. Other risks include dry mouth, wound infection, hematoma, and salivary fistula.

Cure rates exceed 95% for benign tumors with clear margins. Recurrence of pleomorphic adenoma after enucleation (without parotidectomy) is up to 20%; proper parotidectomy reduces recurrence below 2%. 5-year survival for low-grade malignant salivary tumors exceeds 80% with adequate resection.