Salivary Gland Tumours
- The salivary glands produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist. There are many salivary glands e.g. parotid, submandibular, sublingual, and the minor salivary glands.
- Parotid gland is located in front of the ears
- Submandibular gland located below the lower jaw
- Sublingual glands are located below the tongue
- Numerous minor salivary gland is located on the hard and soft palate region
Most common symptoms:
- Swelling (with or without pain) in the neck below the jaw or in front of ears
- Weakness of one half of face
- Swelling in oral cavity, hard or soft palate area
HOW DO WE DIAGNOSE?
To find the cause of symptoms, a surgical oncologist evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. The examination and tests conducted may vary depending on the symptoms. Examination of a sample of tissue under the microscope is always necessary to confirm a diagnosis of cancer.
- A biopsy FNAC is the only sure way to tell whether a person has cancer.
- Laboratory tests examine samples of blood, urine, or cells from the nodes.
- Ultrasound of parotid, neck is first modality.
- CT scan /Magnetic resonance imaging in selected cases.
- PET scan in selected advanced cancers of salivary gland.
If the diagnosis of cancer is confirmed, the surgical oncologist will want to know the stage (or extent) of the disease. Staging is a careful attempt to find out whether cancer has spread and if so, to which parts of the body. Knowing the stage of the disease helps the surgical oncologist plan treatment.
TUMOR BOARD/ MULTISPECIALTY CLINIC EVALUATION
Each and every Head & Neck cancer patient is evaluated by a special team of Surgical Oncologists (Head & Neck unit), Medical Oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology, and stage of the disease, a custom-made treatment plan is charted out for each and every patient as per International Treatment Guidelines. (NCCN – National Comprehensive Cancer Network)
- Superficial Parotidectomy
- Total conservative parotidectomy
- Radical and extended radical parotidectomy
- Facial nerve repair
- Submandibular gland resection
- Facial Reanimation
DO’s after Surgery
- Normal diet.
- All medicines as prescribed in the discharge note along with medicines for chronic diseases like diabetes, hypertension, thyroid-related, and asthma should be continued as earlier.
- You can brush your teeth.
- In the case of free flap reconstruction patient should sleep in a straight position or as advised.
- Walking and moving around is a must.
- Shoulder exercises as and when advised.
- Care of the drain and output charting as advised.
- Care of the wound as advised .
- Care of the eyes if the closure is incomplete with lubricating eye drops every 4 hourly and ointment application plus taping at bedtime.
DON’Ts after surgery
- Avoid hot fomentations.
- Avoid addictions.
- Avoid direct exposure to sunlight if operated for the parotid gland to avoid damage to eyes. Use dark goggles.
When to reach the treating team?
- As per appointment.
- If the swelling around the neck wound or facial wound increases suddenly or within few hours.
- Fresh bleeding from neck or facial wound. Minimal watery discharge during cleaning from neck wound is acceptable.
- If there’s difficulty in breathing or swallowing, fever.
MBBS, MS, M.Ch.
Dr. A.K. Dewan Head & Neck Surgical Oncology
MS(Surgery), MRCS(Edinburg), M.Ch. Surgical Oncology
Dr. Mudit Agarwal Head & Neck Surgical Oncology
Dr. Vikas Arora Head & Neck Surgical Oncology
MBBS, MS, FHNS
Dr. Vishal Yadav Head & Neck Surgical Oncology