Removal of the salivary gland: how is the operation going, possible consequences in the photo

Deleting salivary gland (submandibular, sublingual, parotid) - an operation that is prescribed if it does not function properly, caused by an inflammatory process, blockage with lime stones, the presence tumor-like neoplasm. The expediency of removal is justified by the ineffectiveness of conservative treatment, when it is impossible to restore the activity of the organ in any other way.

Indications for removal

The main reason for the appointment of surgical intervention is the ineffectiveness of conservative therapy.

This often happens with the development of the following diseases:

1. Inflammatory process or sialadenitis. It develops against the background of exposure to a bacterial or viral infection. Symptoms are an increase in the size of the affected area, pain syndrome, a decrease in the volume of salivary fluid production, general malaise.
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2. Abnormal narrowing (widening) of the excretory duct or sialodochitis. Symptoms are increased production of salivary fluid, a salty taste in the mouth, swelling, distention in the mouth, pain while eating, and ear congestion.
3. Formation of stone-like deposits in the lumen of the gland or sialolithiasis. Surgical intervention is prescribed when a calculus reaches a size of 1 mm, which clogs the duct and does not lend itself to washing out by conservative methods. Symptoms - bloating, swelling, unpleasant taste in the mouth, recurrent acute pain, difficulty swallowing saliva. At an advanced stage, general intoxication occurs.
4. Bilateral edema of a non-inflammatory and non-neoplastic nature or sialosis. Symptoms are local pain syndrome, impaired activity of the facial nerve.
5. Mumps or mumps. It develops with an infectious lesion of the body. Symptoms are swelling of the endocrine glands, high fever, loss or decrease in appetite, general malaise, headache.
6. Purulent defeat.
7. The presence of a tumor-like neoplasm.
8. Severe mechanical damage.

With sialodochitis and sialosis, surgical treatment is prescribed in extreme cases, if the edema has reached its maximum size, thereby causing facial asymmetry.

Types of surgical operations

If problems with the functioning of the gland are found, the main task of the doctor is to preserve the glandular tissues.

There are the following types of surgery:

• endoscopy is the most gentle operation, which is prescribed in the presence of a stone-like calculus in the lumen and narrowing of the duct;
• excisional resection cysts, tumor-like formation of a small volume;
• extirpation is an intervention necessary to remove a malignant neoplasm along with nearby lymph nodes, part of the facial nerve, skin (sometimes with bone tissue).

The features of the intervention differ depending on the location of the affected area.

Removal of the submandibular gland

The organ is removed through the external access, cutting the skin in the chin. After excision, the wound is sutured.

To reduce swelling and prevent the accumulation of abnormal fluid, a drainage tube is inserted into the incision through which the exudate comes out. The drainage is removed after 2-3 days.

If the reason for removal is the presence of a tumor-like neoplasm, the excised biological material is sent for histological examination. This will determine the nature of the growth and the presence of malignant cells in it.

The duration of the operation to remove only the affected organ is up to 40 minutes. If excision of nearby tissues or lymph nodes is also required, the time increases to 2-3 hours.

Extirpation on video:

Parotid gland excision

Remove, after making an incision on the cover in the ear fold. If a tumor is present, a superficial parotidectomy is prescribed. The facial nerve and its branches are preserved if the formation does not involve them in the lesion and is located above.

In other cases, when the branches of the nerve are involved in the lesion, extirpation is prescribed, during which the lymphatic network is removed, the underlying tissues are excised.

The duration of the operation is about an hour. The wound is sutured, and a drainage tube is inserted into the incision to remove exudate.

Sublingual extirpation

In this case, the sublingual gland is removed through the mouth. The duration of the operation is up to 30 minutes. Indications for extirpation are a small adenoma, a cyst.

If the neoplasm has reached a significant size, a second access is created through the skin under the chin. In such cases, a complete excision of the organ is required.

Preparation and conduct of the operation

Surgical intervention associated with removal requires preparatory measures.

To identify concomitant diseases that can become an obstacle to surgical intervention, the following studies are prescribed:

• blood tests;
• X-ray diagnostics
• Ultrasound.

Your doctor may ask you to stop taking certain medications 7 days before your surgery, such as non-steroidal anti-inflammatory drugs, blood thinners, and antiplatelet drugs.

Before the intervention on a large gland, general anesthesia is used to avoid pain. When removing small, local anesthesia is used. The operation is performed on an outpatient basis. After the intervention, it is required to stay in the hospital for another 1-2 days.

On the previous day, it is necessary to finish a plentiful meal, to make a cleansing enema. Alcohol and smoking are excluded no later than 2 weeks before the operation. It is forbidden to eat and drink immediately before the intervention.

Next, an operation is performed depending on the area of ​​pathological changes and the characteristics of the development of the primary disease.

The price for the removal of the gland can range from 40 to 95 thousand. rubles depending on the severity of the pathology and the location of the organ.

How is the operation to remove the adenoma of the submandibular salivary gland - video:

Possible complications and consequences

According to numerous reviews of those who have gone through the procedure, complications are rare after the removal of the salivary gland, but the operation does not guarantee the absence of the risk of negative consequences.

Among them:

• paresthesia (partial or complete numbness) of the face and ear from the side of the operated organ;
• violation of the integrity of the nerve responsible for the mobility of the facial muscles;
• ingrowth of salivary nerve fibers into the sweat glands, which is characterized by increased sweating in the operated area;
• hemorrhage;
• accession of a secondary infection with appropriate symptoms;
• swelling of the airway;
• scarring of tissues;
• the formation of a fistulous passage between the mouth and nose, throat, skin;
• with the development of cardiovascular pathology - heart attack, stroke.

The risk group for complications includes people with high blood pressure, diabetes, smoking and alcohol abuse. This also includes elderly patients.

In the photo, facial paresthesia is a possible consequence of the removal of the salivary gland:

Recovery period

The activities of the early recovery period are assigned to the medical worker. The doctor checks the level of functioning of the facial muscles, treats the operated area and the place with a drainage device, and compiles a dietary ration for the patient.

It is recommended to start adhering to the correct diet immediately after discharge from the hospital. Food is served grated, semi-liquid, not hot or cold (optimally at room temperature). Spicy, salty, sour foods are excluded from the diet.

Among the permitted products:

• vegetable puree: from potatoes, carrots, zucchini;
• grated soup from broth cooked in lean meat (chicken or turkey);
• semi-liquid porridge (wheat, oatmeal).

After eating, rinse the mouth with warm water or herbal infusion (from chamomile, calendula, oak bark).

After surgery, the operated person can lead a normal life.

To exclude a relapse of the primary disease and complications, it is enough to adhere to the following simple rules:

• keeping the postoperative department clean;
• cleaning the wound surface with hydrogen peroxide twice a day or antibacterial ointment (as prescribed by a doctor);
• cleansing the operated area with mild soap and water after removing the stitch.

Symptoms such as fever, general malaise, swelling, pain, bleeding, nausea and vomiting, feeling short of breath, and discomfort in the sternum should become a reason for seeking medical attention.

Removal of small glands

More often, surgery on small glands takes place with an adenoma, cyst, calculi in the duct.

Before the operation, the patient is injected with a local anesthetic drug. The operation is performed on an outpatient basis. The stitches are removed after about a week. Features of care, nutrition are similar to those provided after excision of large glands.

In the photo, the seam after the operation:

Gymnastics to restore facial muscles

If the functioning of the facial muscles is impaired, you can perform special exercises: inflate and pull in your cheeks, stretch a smile to the sides, stretch your lips with a tube, close your eyes, wink. Exercise therapy is indicated 2 weeks after surgery. Each exercise is repeated up to 5 times daily. The duration of one exercise therapy session is up to 15 minutes.

Gymnastics for the face, video:

Extirpation of the salivary gland does not apply to operations with a high risk of complications and recurrence of the primary disease. However, to reduce the possibility of negative consequences after the intervention, it is recommended to follow the doctor's recommendations.