Last reviewed by Dr Jingyi Cao, FRACS — August 2026
Condition Overview
Salivary gland surgery treats tumours and stones of the parotid, submandibular, and sublingual glands. Dr Cao provides diagnosis and surgical treatment, including superficial and total parotidectomy with careful facial nerve preservation, submandibular or sublingual gland excision, and removal of ductal stones.
The salivary glands produce saliva and major salivary glands include the parotid glands (in front of the ears), submandibular glands (under the jaw), and sublingual glands (under the tongue).
Conditions treated:
- Benign tumours - pleomorphic adenoma, Warthin’s tumour (most common)
- Malignant tumours - mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, and others
- Sialolithiasis (salivary duct stones) causing obstruction, pain, and infection
Surgical Approach
- Superficial parotidectomy - removal of the superficial lobe of the parotid gland for benign tumours, with careful facial nerve dissection and preservation
- Subtotal or total parotidectomy - removal of part or all of the parotid gland, often with facial nerve preservation where safe, for more extensive disease
- Submandibular gland excision - removal of the submandibular gland for tumours or stones
- Submandibular duct exploration - removal of submandibular duct stones
Facial nerve monitoring is used for all parotid surgery to minimise the risk of facial weakness.
What to Expect
Before Surgery
- Ultrasound and/or CT/MRI for tumour characterisation
- Fine needle aspiration biopsy to determine if the tumour is benign or malignant
- Discussion of risks, particularly facial nerve function
During Surgery
- Surgery is performed under general anaesthetic
- Parotidectomy takes 1-3 hours; submandibular gland excision takes 45-90 minutes
- A surgical drain is usually placed
Recovery
- Hospital stay of 1-2 nights
- Drain removed within 24-48 hours
- Temporary facial weakness is uncommon but can occur; permanent weakness is rare
- Return to normal activities within 1-2 weeks
Frequently Asked Questions
What are the risks of facial nerve injury?
Temporary facial weakness occurs in approximately 5-10% of parotidectomies and usually resolves within weeks to months. Permanent facial nerve injury is rare (less than 1%) with experienced surgeons.
Do all salivary gland lumps need surgery?
Not all salivary gland lumps require surgery. However, it is important to determine the nature of the tumours and their risk of malignancy or of becoming malignant.
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