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SURGERY OF SALIVARY GLANDS

There are several glands producing salivary secretion into the oral cavity. The main glands are a pair of Parotid glands and a pair of Submandibular glands. Parotids produce thin watery saliva and the Submandibulars a little thicker salivary secretion. While chewing any food, addition of liquid saliva secreted by these glands helps in making food items in the mouth into a soft paste, just like adding water in a wet grinder. Even the thought of any tasty food makes saliva flow. Saliva also has some enzymes which help in digesting food.

Diseases of Salivary Glands: Of the various diseases affecting the salivary glands, common conditions are infection, stone formation and tumours - which may be benign or malignant (cancer). Some of the infections in these glands - both Parotid and submandibular- can be controlled by antibiotics; some may need drainage of abscess and some chronic(long standing) infections has to be treated by surgical removal. Most of the tumours - whether benign or cancerous have to be surgically removed.

Tumours of salivary glands :
Parotids : These glands. one on each side, is found below and in front of the ear lobule. It has a superficial and deeper lobe or part between which the delicate nerves of facial expression traverse as five thin thread like branches, very much like the five fingers of the hand. These nerves have to be very carefully identified and safeguarded at surgery. That is why surgery of the parotids is a very delicate and precise operation. The surgeon has to work in an almost bloodless field to preserve the delicate nerves. If the nerves are damaged or were already injured by cancerous invasion in advanced cases, patient will have facial paralysis on the affected side.

Tumours in parotid glands are well known slow growing lesions. In spite of all investigations, including various scans, proper firm diagnosis of cancer is not always possible. Role of some form of biopsy before advising surgical removal is a matter of controversy, since it is feared that it may hasten the spread of cancer. So the best method for all tumours is to remove it completely and subject it to pathological examination (excision biopsy).

Surgery for parotid tumours and rarely for some chronic infections is a very delicate surgical operation. The Late Dr U Mohan Rau used to perform this operation very skillfully. He used to follow a particular method - identifying the individual fine facial nerve branches and then tracing them back to the main trunk of the nerve. But we now follow a simpler and safer method of first identifying the main trunk of the facial nerve and easily trace and follow all branches forward. We Have performed a large number of these operations successfully both in the older and the present new Hospital. We perform "Superficial " or "Total " conservative parotidectomy depending on whether only the superficial or both lobes are diseased.

Submandibulars:
One gland on each side just under the lower jaw bone. Stone formation and chronic Infections are more common in this gland. There are many vital nerves and blood vessels closely attached to the submandibular gland. Hence surgical removal of this gland - both its superficial and deep lobes - called as Submandibular Sialadenectomy - is also a delicate operation. A large number of these operations have also been conducted in the old "Surgical Clinic" and the present " Dr. U Mohan Rau Memorial Hospital.

Stones (Calculi) in submandibular gland's main duct can often be performed by a simple operation from inside the mouth.

THE DELICATE OPERATIONS ON THE SALIVARY GLANDS IS ALSO ONE MORE OF OUR STRENGTHS !

Please feel free to seek any information or clarifications on this subject of Surgery of the Salivary Glands

With Best Wishes to Be Healthy,
Yours Sincerely,

Dr. M.Mohan Rao, MBBS, MS, FICS, MCH,
M.D. & Chief Surgeon,
Dr. UMR Memorial Hospital.
962, Poonamallee High Road, Chennai 600084.
Tel. 6424396, 6411621, 6412474.
E-mail: mmr@mohanraohospital.com

 

 

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Updated on 15.10.2002.
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