Salivary Gland Disorders

The salivary glands produce saliva to moisten the mouth, help protect teeth from decay and to help in the digestion of food. There are three major salivary glands: the parotid (on the cheek and under the ear), submandibular (under the jaw), and sublingual (under the tongue) glands.

Signs and symptoms

Symptoms of salivary gland disorder can include:

• Blocked saliva flow
• Difficulty eating
• Swelling in the gland(s) of the cheek and neck
• Pain in the gland(s)
• Repeated infections
• Growths or lumps inside the glands or neck

Causes

Saliva obstruction

Saliva flow can be blocked in the parotid and submandibular glands or ducts either by stones or narrowing inside the ducts. A blocked saliva duct can lead to pain and swelling of the saliva gland. Typically, the glands will swell during a meal for a few minutes before gradually subsiding, only to enlarge again at the next meal. Infection with severe pain and swelling can develop if the gland is blocked for a long time without the ability to release the built-up saliva. If persistent gland swelling is left untreated, the glands may develop a severe infection or abscess.

You may experience a swelling or enlargement of nearby lymph nodes with salivary blockage.

Tumors

Cancerous or noncancerous tumors usually show up as painless lumps or enlargements. Tumors rarely involve more than one gland and are detected as a growth in the parotid, submandibular area, on the palate, floor of mouth, cheeks, or lips.

Cancerous tumors of the major salivary glands can grow quickly, may be painful, and can cause loss of movement in part, or all, of the affected side of the face. These symptoms should also be checked immediately by an ENT specialist.

Other disorders

Enlarged or inflamed salivary glands can also be caused by autoimmune diseases, such as HIV and Sjögren’s syndrome, where the body’s immune system attacks the salivary glands. Dry mouth or dry eyes are symptoms of Sjögren’s syndrome. This may occur with other systemic diseases, such as rheumatoid arthritis. Diabetes may cause painless enlargement of the salivary glands, especially the parotid glands.

Treatment

Treatment of salivary diseases falls into two categories—medical and surgical—and depends on the nature of the problem. If it is due to diseases or disorders that involve the whole body, not one isolated area, then the underlying problem must be treated. This may require consulting with other specialists. If the disorder relates to salivary gland obstruction and infection, our ENT specialists may prescribe antibiotics and recommend increasing your fluids.

If a mass has developed within the salivary gland, removal of the mass may be recommended. Most masses in the parotid gland area are noncancerous. When cancerous masses are located within the parotid gland, it may be possible to surgically remove them while preserving most of the facial nerve within the gland that moves the face muscles, including those for the mouth and eyes. Radiation treatment is sometimes recommended after surgery.

The same general principles apply to masses in the submandibular area or in the minor salivary glands within the mouth and upper throat. Noncancerous masses are best treated by conservative measures or surgery. If the lump in the vicinity of a salivary gland is a lymph node that has become enlarged due to cancer from another site, your ENT specialist will recommend a different treatment plan.