Maxillofacial oncology
Salivary Gland Tumours — Parotid and Submandibular Glands
Assessment and surgical treatment of lumps in the parotid and submandibular salivary glands.
Overview
Also known as: parotid tumour, submandibular gland tumour, lump in front of the ear, parotidectomy
The major salivary glands are the parotid gland, located in front of and below the ear, and the submandibular gland beneath the lower jaw. Tumours can develop in these glands and may be benign or malignant. The type of lump can only be established through investigation.
The parotid gland lies in close relation to the facial nerve, which controls the muscles of facial expression. Any procedure in this area is therefore planned with the course of the nerve and its preservation in mind. Surgery on the parotid gland is called parotidectomy.
Diagnosis usually involves a clinical examination, imaging (for example ultrasound, CT or MRI) and, where needed, taking a tissue sample for analysis. When the disease is malignant, treatment is discussed and planned by a multidisciplinary team.
When to seek a consultation
- A swelling or lump in front of the ear, below the ear or under the lower jaw.
- A lump that is gradually growing or does not go away.
- Pain, numbness or weakness of the facial muscles on one side.
- A change in a lump that has been present for a long time.
What treatment may involve
- An examination and imaging to clarify the size and position of the lump.
- Where needed, taking a tissue sample before treatment is planned.
- Surgical removal of the tumour together with the affected part of the gland or the whole gland, depending on the findings.
- Histological examination of the removed tissue, which establishes the final diagnosis.
- For malignant disease, review by a multidisciplinary team and, where needed, further treatment.
What to bring to the consultation
- An identity document and, where applicable, a referral from your GP or specialist.
- Existing medical records: discharge summaries, outpatient notes and test results.
- Imaging studies (X-rays, CT, MRI) on a disc or other digital medium, together with the written reports.
- A list of your current medicines, known allergies and chronic conditions.
- Histology reports and oncology board opinions, if available.
Recovery and follow-up
Recovery depends on the type and extent of the operation. In the first days there may be swelling, numbness in the area and discomfort, which usually settle gradually.
The histology result and the next steps are discussed at a follow-up appointment. For some types of tumour, longer-term follow-up is recommended.
Risks and alternatives
Specific risks include temporary or longer-lasting weakness of the facial muscles because of the nearby facial nerve, numbness around the ear, fluid collecting in the wound, sweating of the cheek when eating and a visible scar. The likelihood of each depends on the size and position of the tumour and is discussed individually.
Alternatives — including observation for certain findings — are discussed once investigations are complete. Declining investigation or treatment of an undiagnosed lump also carries risks that are important to understand.
Every surgical procedure carries general risks — for example those related to anaesthesia, bleeding, infection, delayed healing or scarring. The specific risks depend on your health, and on the type and extent of the procedure.
Possible alternatives — including observation, non-surgical treatment or referral to another specialist — are discussed openly during the consultation.
Outcomes and recovery time vary between individuals and cannot be guaranteed in advance.
Frequently asked questions
Is a lump in front of the ear dangerous?
A lump in this area can have various causes, including a parotid gland tumour. Only an examination and investigations can show what it is, so it is best not to delay an assessment.
What is a parotidectomy?
A parotidectomy is an operation to remove part or all of the parotid gland. Its extent depends on the type and position of the lump.
Can the operation affect the facial nerve?
The facial nerve runs through the parotid gland, and protecting it is part of planning the operation. The risk of it being affected depends on the specific findings and is discussed beforehand.
How much does salivary gland surgery cost?
The cost depends on the investigations needed and the type of treatment. It is discussed after a consultation, once a plan has been agreed.
This information does not replace a medical examination. Whether treatment is suitable for you is assessed individually after a consultation.