FACIAL SURGERY

Salivary gland surgery

Swellings or lumps within the salivary glands are a relatively common problem and can be caused by blockages in the glands such as stones or mucus plugs, or can be due to tumours within the glands. These lesions need to be investigated carefully, usually with the use of imaging and sometimes biopsies.

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Salivary gland surgery, clinical reference

Quick answer about this procedure

QUICK ANSWER

Surgical management of salivary gland conditions including stones, mucus plugs and tumours. Depending on the cause, treatment ranges from intra-oral stone release (IOSR) for stones within the duct to surgical removal of the affected gland.

Procedure
Intra-oral stone release (IOSR) / gland removal
Anaesthesia
Local · Sedation · GA
Duration
30 min – 3 hrs
Stay
Day-stay or hospital
Recovery
1–3 weeks depending on procedure

IS THIS FOR YOU?

Salivary gland surgery is usually considered when:

  • There is recurrent painful swelling of a salivary gland, particularly with eating
  • Imaging confirms a stone (sialolithiasis) within a duct or gland
  • A persistent lump in a salivary gland needs definitive diagnosis
  • A salivary gland tumour requires surgical removal
  • A ductal stone may be treatable with intra-oral stone release (IOSR)

Understanding the anatomy

Cross-section illustration of the lower face showing a salivary gland, its duct, and a small stone lodged within the duct.
A stone can block the duct that drains a salivary gland, causing pain and swelling; surgery removes the stone or, when needed, the gland.
WHO PERFORMS THIS

The surgeons who perform this procedure

All three surgeons listed below perform this procedure at OMS Specialists. Each carries dual qualifications in medicine and dentistry plus fellowship from the Royal Australasian or English College of Surgeons.

Mr Richard Cobb, Specialist Oral and Maxillofacial Surgeon

Mr Richard Cobb

Specialist Oral & Maxillofacial Surgeon

MBBS · BDS · MFDS(Eng.) · MRCS(Eng.) · DHMSA · FRCS (Maxfac.)

  • Oral Surgery
  • Jaw Surgery
  • Facial Surgery
  • Skin Surgery
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Mr Ryan Smit, Specialist Oral and Maxillofacial Surgeon

Mr Ryan Smit

Specialist Oral & Maxillofacial Surgeon

BDS · MBChB · MRACDS(PDS) · FRACDS(OMS)

  • Oral Surgery
  • Jaw Surgery
  • Facial Surgery
  • Skin Surgery
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Mr Simon Roberts, Specialist Oral and Maxillofacial Surgeon

Mr Simon Roberts

Specialist Oral & Maxillofacial Surgeon

MBBS · BDS · FRCS(OMFS)

  • Oral Surgery
  • Jaw Surgery
  • Facial Surgery
  • Skin Surgery
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RECOVERY TIMELINE

Recovery timeline

  • 0–7 days

    Intra-oral stone release (IOSR)

    Day-stay procedure under local anaesthesia with sedation, or general anaesthesia. Soft diet, simple analgesia and rapid return to normal activity within a few days.

    Red flags · Severe swelling, fever over 38°C, or inability to swallow fluids.

  • 1–3 weeks

    Gland removal

    Hospital admission for open gland removal. Soft diet for several days, dressings to any external wound, and return to desk-based work usually within 1 to 2 weeks.

  • 1–6 months

    Long-term

    Continued healing and, where a gland has been removed, the remaining salivary glands compensate for normal saliva production over time.

RISKS & HONESTY

Risks we discuss before consent

  • Facial nerve injury (parotid)

    The branches of the facial nerve pass through the parotid gland. Careful surgical technique minimises the risk of temporary or permanent weakness of the muscles of facial expression.

  • Recurrence

    Stones and mucus plugs can recur after intra-oral stone release. Definitive gland removal is considered for recurrent cases.

  • Scarring

    Open gland removal leaves an external scar that fades over months. Intra-oral stone release leaves no external scar.

  • Altered sensation or taste

    Numbness around the surgical site or altered taste can occur transiently and usually recovers.

FREQUENTLY ASKED

Common questions about salivary gland surgery

What is intra-oral stone release (IOSR)?

Intra-oral stone release (IOSR) removes a stone from the salivary duct through the inside of the mouth, with no external incision or scar. It is performed under local anaesthesia with sedation, or general anaesthesia, and most patients are home the same day. When stones recur or a gland is persistently affected, surgical removal of the gland may be recommended.

How do I know if I need surgery or just observation?

Swellings or lumps within the salivary glands are a relatively common problem and can be caused by blockages in the glands such as stones or mucus plugs or can be due to tumours within the glands. These lesions need to be investigated carefully, usually with the use of imaging and sometimes biopsies. The treatment plan depends on the diagnosis and is discussed in detail at consultation.

Will I have a visible scar?

Intra-oral stone release leaves no external scar. Open removal of a salivary gland (particularly the parotid) leaves an external scar that fades over months and is usually well-camouflaged in the natural skin creases.

Will I lose my sense of taste or have a dry mouth?

The salivary glands work together, and removing one gland rarely causes a noticeably dry mouth because the remaining glands compensate. Altered taste around the surgical site can occur transiently and usually recovers.

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