Drs. Rohn and Gamble specialize in minimally invasive salivary gland surgery called sialoendoscopy. Sialoendoscopy entails placing a small telescope into the salivary glands through the salivary ducts that empty into the mouth.
Minimally Invasive Salivary Gland Surgery
Sialoendoscopy is performed in the operating room under general anesthesia. Salivary gland stones (calculi) is termed sialolithiasis. Symptoms are swollen and painful salivary glands, which are located throughout the mouth and neck. The three main paired salivary glands are the submandibular glands, the parotid glands, and the sublingual glands. When a calcified mass becomes stuck in the duct that drains the gland, treatment is removal of the mass from the duct.
All three of these glands can develop tumors, but the most common occurrence is within the parotid gland. In most cases, these tumors are not cancerous (benign), but in 25% of cases, the tumor is cancerous (malignant).
Causes of Salivary Gland Stones
Stones can develop when certain substances in your saliva, particularly calcium phosphate and calcium carbonate, crystalize and develop stones that can be as small as a few millimeters and up to larger than two centimeters.
When these stones occur and block your salivary glands, it creates a build-up of saliva in your ducts, causing them to swell. It is not certain exactly why these stones are formed, but their development has been linked to the following:
- Taking medications, especially for blood pressure and antihistamines, which cause a reduction in the amount of saliva your glands produce
- Dehydration, which makes your saliva more concentrated than usual
- Not eating enough food or starvation, which lowers the amount of saliva you produce
Symptoms of Salivary Gland Stones
The predominant symptom of these stones is pain in your face, mouth and neck that often increases just before or during mealtimes. The reason for this is that your salivary glands produce saliva to facilitate eating and digestion. When the salivary ducts are blocked, the glands become swollen with the backed up saliva, which causes the swelling and pain. Other common symptoms include tenderness and swelling in the face, mouth and neck, fever, as well as dry mouth or trouble swallowing.
Salivary Gland Tumors
The most common occurrence of salivary gland tumors is seen in the parotid gland. Predominantly, these tumors are not cancerous (benign), and surgery should be the only treatment required. However, the presence of cancerous (malignant) tumors can mean that additional treatment is necessary after surgery. There are additional symptoms that may indicate a tumor, rather than just a salivary gland stone:
- Changed facial shape and symmetry
- Neck mass
- Problems opening the mouth
- Problems with eating and swallowing
Diagnosis of Parotid Gland Tumors
You will be referred to a head and neck surgeon, like Drs. Greg Rohn and Brad Gamble, for a full examination if your health care provider or primary care physician suspects you may have a tumor. If you believe you may have an abnormal growth, you can also self-refer. A full examination may include an MRI scan or CT scan to fully determine the size and location of the growth. To test for malignant cells, a Fine Needle Aspiration Biopsy (FNAB) may be performed, which involves taking a small amount of tissue from the parotid gland.
Salivary Gland Surgery – Treatment for Salivary Gland Stones and Tumors
Sialoendoscopy is an efficient and minimally invasive treatment to remove salivary gland stones and to treat salivary gland inflammation, and can be performed under general anesthetic in the operating room. Sialoendoscopy is a procedure that requires state-of-the-art telescope and video technology. As a result of these developments, salivary gland stone and inflammation treatment is able to be done in a non-invasive way that eliminates the possibility of long term scarring and other possible side effects that can occur with removal of the affected salivary gland. The process involves inserting the endoscope into an incision or dilation in the gland, and then using one of the following techniques to remove the stone:
- The grasping technique
- Using a small wire basket for retrieval
- Mechanical Fragmentation
Salivary gland tumors require surgery for treatment. This generally involves removal of the affected saliva gland including the tumor.
Dr. Rohn, Dr. Gamble and Dr. Kubala are ENT, sinus, and head and neck surgeons with offices located in Plano and Dallas. If you would like to schedule an appointment with our office, please call our Plano office at 972-378-0633 or Dallas office at 214-239-1641.