Salivary glands are glands in your head and neck region whose main function is to produce saliva.  Saliva contains enzymes that help digest food and antibodies to protect against infections of the mouth and throat.

There are 3 major pairs of salivary glands:

• Parotid glands - These are the largest salivary glands and are found in front of and just below each ear.  The majority of salivary gland tumours are found in this gland.
• Submandibular glands - These glands are just below the jawbone
• Sublingual glands - These glands are found under the tongue in the floor of the mouth

Along with innumerable (600-1000) minor salivary glands within the mouth. Common problems related to salivary glands are tumours (lumps), stones and infection.

Tumours

A tumour refers to an abnormal growth and can either be benign (non-cancerous) or malignant (cancer).  Tumours affecting the salivary glands are diverse in their pathology and 80% occurs within the parotid gland.  The diagnosis is obtained via a fine needle aspirate (FNA) - under ultrasound guidance, the radiologist/pathologist uses a small needle to take a sample of cells from the lump and look at it under the microscope.

Treatment

For benign lumps, treatment depends on the type of tumour.  Surgery is typically recommended for tumours causing symptoms or those with a risk of malignant transformation (developing into cancer).

For cancers, treatment typically involves removing the tumour with the entire salivary gland and the draining lymph nodes in the neck followed by post-operative radiotherapy.

Stones

Salivary gland stones are calcified structures that may form within a salivary gland or duct.  Once it reaches a certain size, it blocks the flow of saliva into the mouth causing the saliva to back up resulting in pain, swelling and infections.  Salivary stones most commonly affect the submandibular gland but can occasionally affect the parotid and sublingual glands.
Once you have been diagnosed with a salivary stone, your doctor will often confirm the diagnosis with a CT scan or ultrasound.

Treatment

Once a stone has been identified, the aim is to remove it.  The majority of patients only become aware of the stone after they have developed several attacks of pain.
Depending on the location of the stone, it can sometimes be removed via a small cut on the inside of the mouth.
For patients with large stones, recurrent stones or irreversible damage to the gland, surgery to remove the gland may be necessary.