Salivary gland diseases usually manifest themselves with swelling under the face or chin. In general, these swellings often occur during eating and gradually shrink and disappear after eating. If this salivary gland canal is completely blocked, the swelling does not go away completely and may be permanent.This swelling may be painful from time to time, if it has caused inflammation of the salivary gland, redness and temperature increase may also be observed on it.
Swelling of the salivary gland is caused by the following diseases:
Formation of salivary gland stones (the most common cause).
Formation of duct stenosis in the salivary gland
Blockage of salivary gland duct plugs
Inflammation of the salivary gland
Anatomical disorders of the salivary gland canal
Recurrent salivary gland inflammations in children
Channel blockages and adhesions that occur after radiation therapy, after the treatment of thyroid diseases (thyroid cancers)
Foreign objects that block the salivary duct (such as hair strands, tea, bones)
Connective tissue diseases in adults
Salivary gland tumors
The Non-Surgical Period has Started for Salivary Gland Stones
Although it is not as widely known among our society as gallbladder and kidney stones, stony diseases that can be seen in the salivary glands can affect a person’s life very badly. Dec. Stones can form in the large salivary glands, which are located in two grains on our cheeks and under our chins.
What are the symptoms of salivary gland stones?
Symptoms of the disease appear when these stones block the channels of the salivary gland that drain water into our mouth. The most common symptom we encounter is painful swelling that occurs on the cheeks and under the chin while eating. If in this case, sour and acidic foods that stimulate salivary secretion can lead to more pronounced swelling in the salivary glands, and if the salivary gland duct is not completely blocked, these painful swellings gradually shrink spontaneously after eating. If these swellings do not shrink immediately, they cause a lot of pain and if they get hot, it means that inflammation in the salivary gland has also started.
When do salivary gland stones give symptoms?
With the growth of stones in the salivary gland, the channels that drain saliva become blocked, and therefore the salivary gland swells and suddenly bothers the patient, especially during meals. The salivary gland channels are 2-3 mili meters in diameter, and a stone that has reached these dimensions also prevents the salivary secretion from coming out. Sometimes it can be in motion in this salivary gland canal. For this reason, because the channel is sometimes open, sometimes closed, the patient’s complaints may not always be. Usually, salivary gland swellings begin to shrink when the canal is opened and may return to their former state until the canal is blocked again. However, it is known by experts that “salivary gland stones grow up to 1 millimeter every year, eventually they completely block the canal “and the patient’s painful swellings do not go away on their own. As a remedy for this, surgery should be performed.
How is the diagnosis of salivary gland diseases made?
In patients who apply to our hospital with a complaint of salivary gland swelling, a simple otolaryngology examination is performed first. Then, it is requested to perform an ultrasonographic examination of the swelling on the face or under the chin. Stones around 3 millimeters located in the salivary gland can be seen on ultrasound, stones that are smaller may not be detected, but this can give symptoms such as canal enlargement. In suspicious cases, a tomography scan may also be requested. Or instead, as is the case today, the inside of the salivary gland canal can be looked at directly by endoscopic method, and thus both the diagnosis of the disease can be made and the treatment along with the diagnosis can be done at the same time. This method is also called endoscopy of the salivary glands.
How is the treatment of salivary gland stones performed?
In stones that did not completely block the canal until today’s technology, the patient tried to be treated with recurrent antibiotics and painkillers, and if the stone completely blocked the canal, the entire salivary gland was surgically removed. But with today’s technology, with the help of an endoscope that can enter through the channels of the salivary gland, these stones can be removed and removed from the canal, and the patient completely gets rid of these troubles. In medical language, we call this method an endoscopic intra-ductal intervention into the salivary gland. Usually, in order for this process to be performed, it is necessary that the stone diameter should not be too much larger than the channel diameter. But in some cases, by breaking large stones into smaller pieces with a laser or shock wave stone crushing devices, we can then be removed from the same channel again. If there are very large stones, we can remove them through a surgical procedure performed by combining them with an endoscopic approach, since this method cannot be allowed. In addition to preventive methods, extensive surgeries can also be applied to remove the salivary gland, but it is necessary to tell patients that these methods will not be appropriate.
How does Salivary Gland Inflammation develop?
We humans are called salivary gland disease, and the most common condition is a salivary gland stone or salivary gland inflammation. But first, inflammation of the salivary gland develops, and then it leads to the formation of stones. Or vice versa, the salivary gland canal is blocked by a salivary gland stone, and this leads to inflammation of the salivary gland. In general, recurrent salivary gland inflammations can lead to narrowing or blockage of the salivary ducts. Because of this, it causes the inflammatory process to continue by repeating. Opening and cleaning these channels with the technique we call sialendoscopy provides an effective treatment method by ensuring that the salivary gland returns to normal. But there are also chronic salivary gland inflammations due to repeated enlargements of the salivary ducts. In addition, today, some goiter patients may experience recurrent salivary gland inflammation, manifested by salivary gland swelling after radio iodine (atomic therapy), also known as radioactive iodine (RAI) therapy. In this case, the most effective diagnosis and treatment method is sialendoscopic endoscopy technique.
How Are Classic Salivary Gland Surgeries Performed?
With the increasing high success rates of sialendoscopy technique today, classical open salivary gland surgeries have also become less and less performed. In centers with sialendoscopy facilities, open salivary gland surgeries are considered as the last option.For the salivary gland under the chin, in cases where the stone cannot be removed by sialendoscopic intervention, or in cases of a tumor, salivary gland surgery is also performed in the form of removing the entire salivary gland. The most well-known risk of this surgery is temporary or permanent paralysis of the lip corner in the area with swelling. In addition, classic operations of the salivary glands should also be performed in centers where highly specialized physicians are present. These undesirable situations are not seen often. But Decrement of taste sensation on the tongue, wound infection, bleeding and scarring can also be counted among other undesirable conditions.
The most important risk of classic cheek salivary gland surgeries is that the main branches of the facial nerve are damaged during surgery, in which case there may be partial or complete facial paralysis. For this reason, open surgery operations on the salivary gland of the cheek are not applied immediately except for tumors. Sialendoscopy technique is considered as the first option for stones, especially in the salivary gland of the cheek. In cheek salivary gland surgeries, other undesirable conditions experienced in operations of the salivary glands under the jaw may also be observed. However, in mandatory cases, open salivary gland surgeries can be performed in safe centers by experienced specialists in their field.