Salivary gland surgery

Introduction to Salivary Gland Issues

Everyone has six major salivary glands and numerous minor ones. Problems in these glands are generally caused by inflammation, stone formation resulting in obstruction of saliva flow, or tumor formation.

I provide a wide range of surgical procedures for both minor and major salivary glands. This includes traditional open surgery as well as endoscopic and minimally invasive techniques like sialoendoscopy.

Introduction to Salivary Gland Issues

Sialoendoscopy: A Minimally Invasive Technique

Sialoendoscopy is a state-of-the-art technique involving the insertion of a very small scope (1.1 to 1.7 mm in diameter) into the major salivary gland’s drainage system. This method allows for the removal of obstructions, such as stones, and the dilatation of narrowed or scarred drainage systems. The procedure eliminates the need for surgical incisions and preserves the affected gland.

A diagram showing the sialoendoscope being inserted into the drainage system of a major salivary gland with a front loading basket inserted through the working channel (A). The stone was then trapped within the basket and removed from within the drainage system eliminated the need for any surgical incisions and preserving the affected gland.

Traditionally, major salivary gland obstruction often involved removing the entire gland, which came with risks like scarring and nerve damage. With sialoendoscopy, it’s now possible to extract stones with no skin incisions, preserving the salivary gland in a significant number of patients.

A

B

Invasive Surgical Procedures

In addition to endoscopic management, I also offer more invasive surgical procedures, including:

Sialoendoscopy of major salivary glands (e.g., parotidectomy, excision of ranula or mucocele)
Surgical removal of major or minor salivary glands
Tissue biopsies

During procedures like parotidectomy, nerve monitor electrodes are used to monitor the facial nerve, reducing the risk of facial weakness.

When to Seek Referral

Consider seeking a referral if you notice:

A sudden or slowly growing lump in front of or below the ear, the jawline, under the tongue, or in the roof of the mouth.
Painful swelling, especially if associated with mealtime, indicating salivary flow obstruction.
A saliva-filled blister on the lower lip, under the tongue, or cheek.
Symptoms like dry mouth, gritty eyes, or painful joints.

Where to Refer?

Private:
Auckland Head & Neck Specialists, MercyAscot,
100 Mountain Road Epsom.
E-mail: info@ahns.co.nz

Greville Dental (Visiting Surgeon), 18 Hauraki Crescent, Pinehill. E-mail: info@ofhnsurgery.co.nz