Salivary gland surgery at Assuta is performed by specialist ENT surgeons

Salivary gland surgery requires a high level of expertise and professional experience, because the
face and head are extremely sensitive and their nerves are very vulnerable.

About the salivary glands

The salivary glands are responsible for producing saliva, of one of the body's most important fluids.
Saliva aids in initially breaking down and digesting the food we eat, protecting the teeth and mouth,
and helping prevent contaminants or foreign and dangerous substances from entering the body. The
mouth has several hundred salivary glands, and significant damage to their functioning sometimes
requires surgical intervention.

The role and structure of the salivary glands

The salivary glands consist of tiny tubes, through which the saliva produced passes into the mouth.

Three pairs of glands are considered primary and central in this system:

• Parotid glands: The largest pair of glands, located on both sides of the head, just below the
  ears
• Submandibular glands: Located under the jaw, at the top of the throat on both sides
• Sublingual glands: Located below the tongue, on the floor of the mouth

In addition to these six glands (three pairs), the mouth and upper respiratory system have many
other tiny salivary glands.Despite their small sizes, they are also immensely important in producing
the amount of saliva required for proper body functioning.

Salivary gland problems

A number of conditions can cause swelling or enlargement of the parotid glands:

• Acute or chronic inflammation of the salivary glands and other diseases of the salivary glands that do not cause tumors
  
  
• Salivary stone formation in the salivary glands: The stones can block the glands’ drainage ducts,
  causing swelling,pain, and inflammation. To diagnose this problem, patients undergo a physical
  exam, imaging scans, or laboratory tests.Surgeons remove the stones using either a standard
  surgical technique or endoscopic surgery (via a long, flexible tube inserted through the mouth),
  depending on the situation.
  
  
• Salivary gland tumors: Most often, the lump is detected by self-examination. Although the lump
  is usually painless, the tumor must be assessed to determine whether it is benign (non-
  cancerous) or malignant (cancerous).

Surgery of the parotid gland to remove a benign tumor

Most benign parotid gland tumor surgeries are conservative.The surgeon removes the tumor and
healthy tissue around the nerve; the entire gland does not need to be removed.

Surgery of the parotid gland to remove a malignant tumor

About 20% of parotid gland tumors are malignant. When a doctor finds a malignant tumor, the
recommended treatment is to resect (remove) it. Assuta surgeons have experience and targeted
expertise in these procedures.

To remove the cancerous tumor, the surgeon resects it, while removing a small amount of healthy
tissue around it to make sure all the cancer has been removed.

If one or more of the following situations is present, the patient may require more extensive surgery,
which may include removing the lymph nodes and surrounding tissue from the neck:

• When the patient is diagnosed with metastases to the lymph nodes
  
  
• When there is a high risk of lymph node metastases
  
  
• When the patient has a high-grade salivary gland tumor (high grade of malignancy)
  
  
• When the salivary gland tumors are large

Salivary gland endoscopy

A salivary gland endoscopy performed at Assuta is a breakthrough medical procedure that often
eliminates the need for salivary gland resection.

About salivary gland endoscopy

Surgeons use this small surgical intervention to diagnose and treat cases of salivary gland
obstruction.This medical condition delays or completely blocks saliva from reaching the mouth. It is
caused by the accumulation of salivary stones or constrictions in the ducts that empty the glands.
This condition causes problems for the patient such as swelling and a bacterial infection.

Endoscopic salivary gland surgery

This procedure eliminates the need to cut out a patient’s affected gland. The surgeon inserts an
endoscope (a thin illuminated optical tube) into the glandular pathways to locate the blockage and
remove it. The endoscope can also be used to diagnose other salivary gland conditions.

In most cases, the endoscopy is performed under local anesthesia, while complicated cases are
performed under general anesthesia. The endoscopic surgery does not leave external scars or
incisions, and the risks and chances of complications are low. When the operation is performed
under local anesthesia, the patient must remain in the clinic for a while after the procedure.When
the operation is performed under general anesthesia, the patient remains in the hospital under
observation and is discharged the following day.