Understanding Salivary Gland Surgery: Unignored Symptoms

     When it comes to abnormalities in the face and neck area, many people might only think of toothaches or inflamed lymph nodes. However, there is another vital organ that cannot be overlooked—the “Salivary Glands.” As an Otolaryngologist (ENT Specialist), I always emphasize to my patients that even a small abnormality, such as a slow-growing lump in front of the ear or under the jaw, may be a signal from the body that it’s time for serious care.

Reasons for Salivary Gland Surgery

We have three pairs of major salivary glands: the Parotid gland (in front of the ears), the Submandibular gland (under the jaw), and the Sublingual gland (under the tongue). Most reasons for surgery stem from two main factors:

• Salivary Gland Tumors: Whether benign or malignant (cancerous), surgery is the gold standard of treatment to prevent further spread.
• Salivary Stones: These often cause blockages, recurring inflammation, and significant pain while eating.

Delicacy is Key: Treatment Beyond Just Surgery

     Many people worry, "Will my face be distorted after surgery?" or "Will there be a long scar?" I understand these concerns well. The heart of salivary gland surgery, especially the parotid gland, is "preserving the Facial Nerve," which controls facial muscles and is sandwiched between the superficial and deep lobes of the parotid gland.

Ramkhamhaeng Hospital prioritizes Precision Surgery

• Intraoperative Nerve Monitor: We use specialized equipment to track nerve function during surgery to minimize the risk of nerve injury.
• Aesthetic Incision: We emphasize aesthetic results by hiding incisions along natural skin creases or behind the ear, allowing patients to return to their lives with confidence.
• Innovative Surgery: Removal of salivary duct stones through endoscopy or intraoral surgery.

'Salivary Gland Surgery' and Specialized Techniques

It is crucial that the surgeon selects the most appropriate technique for the location of the lesion to ensure effective treatment and minimize the impact on the patient's body.

1. Sublingual Gland Surgery or Oral Floor Cyst Removal

     For patients with a soft swelling under the tongue or obstructive inflammation, surgery focuses on removing the lesion directly through the mouth. This helps reduce the risk of injury to the taste nerves and the main salivary duct.

2. Transoral Submandibular Gland Removal

     An advanced technique that eases concerns: the surgeon performs the procedure through the oral cavity using endoscopic guidance. This allows the problematic gland to be removed with "no external skin scars."

3. Minimally Invasive Parotid Tumor Surgery

     In the case of parotid tumors, I utilize a meticulous technique to separate the tumor from normal tissue, known as Extracapsular Dissection, combined with a small incision. This minimizes tissue disruption and, most importantly, "reduces impact on the facial nerves" as much as possible. Patients can still move their faces and smile naturally after surgery.

Endoscopic Salivary Gland Surgery (Sialendoscopy)

     In addition to standard open surgery, we now have surgical innovations that further "preserve tissue." This is Sialendoscopy. This method is like sending a tiny "eye" with a diameter of only a few millimeters to explore directly inside the salivary duct.

Advantages of Sialendoscopy

This technology allows us to treat Salivary Stones or ductal stenosis "without any external surgical wounds." The doctor inserts the scope through the natural opening of the duct in the mouth to retrieve or break up stones. The key benefits are:

• Reduced Trauma: No need to remove the entire gland if the glandular tissue is still functioning well.
• Scar-free: Since the procedure is performed through the natural openings in the oral cavity.
• Fast Recovery: Patients can return to eating and normal activities faster than conventional surgery.

"My goal is not just to eliminate tumors or diseases, but to restore your smile and quality of life, ensuring you remain the most complete version of yourself."