If you have salivary gland cancer, one of the first things your doctor will do is to determine if the cancer is resectable (removable by surgery). Surgery is usually the main form of treatment for resectable salivary gland cancers.

In most cases, the cancer and some or all of the surrounding salivary gland will be removed. Nearby areas of soft tissue may be removed as well. If the cancer is high grade (more likely to grow and spread quickly) or if it has already spread to lymph nodes, the surgeon will usually remove lymph nodes from the same side of the neck in an operation called a neck dissection.

Before surgery, ask your surgeon exactly what will be done during the operation, whether there are other options, and what side effects you can expect. Make sure that your surgeon has experience treating salivary gland cancers.

Salivary gland surgery

They type of surgery will depend on which salivary gland is affected.

Parotid gland surgery: Most salivary gland tumors occur in the parotid gland. Surgery here is complicated by the fact that the facial nerve, which controls movement on the same side of the face, passes through the gland. For these operations, a cut (incision) is made in the skin in front of the ear and may extend down to the neck.

Most parotid gland cancers start in the outside part of the gland, called the superficial lobe. These can be treated by removing only this lobe, which is called a superficial parotidectomy. This usually spares the facial nerve and does not interfere with facial movement.

If your cancer has spread into deeper tissues, the surgeon will remove the entire gland and might also remove your facial nerve. This operation is called a total parotidectomy. If your surgeon has mentioned this surgery as a possibility, ask about operations to repair the nerve and ways to treat side effects caused by removing the nerve. If the cancer has invaded other tissues near your parotid gland, these tissues might also need to be removed.

Submandibular or sublingual gland surgery: If your cancer is in the submandibular or sublingual glands, the surgeon will remove the entire gland and perhaps some of the surrounding tissue or bone. Several important nerves pass through or near these glands. These nerves control tongue movement, as well as sensation and taste. Depending on the size and location of the cancer, the surgeon may need to remove some of these nerves.

Minor salivary gland surgery: Minor salivary gland cancers can occur in your lips, tongue, hard and soft palate, oral cavity, throat, voice box (larynx), nose, and sinuses. The surgeon usually removes some surrounding tissue along with the cancer. The exact details of surgery depend on the size and location of the cancer.

Possible risks and side effects of salivary gland surgery: With any salivary gland cancer surgery, the surgeon may need to cut through your skin or your mouth. You may have problems with anesthesia or with wound healing, infections, or excessive bleeding during or after surgery. Most people will have some pain for a time after the operation, although this can usually be controlled with medicines.

If your facial nerve is damaged during surgery, you may lose control of your facial muscles on the side the surgery was done and your mouth may droop. Damage to other nerves may cause problems with speech or swallowing.

Sometimes, nerves cut during surgery grow back abnormally and become connected to the sweat glands of the face. This condition, called Frey syndrome or "gustatory sweating", results in flushing or sweating over areas of your face when you chew. Frey syndrome can be treated with medicines or with additional surgery.

Depending on the extent of the operation needed, your appearance may be changed as a result of surgery. This can range from a simple scar on the side of the face or neck to more extensive changes if nerves, parts of bones, or other structures need to be removed. It's important to talk with your doctor before the surgery about what these changes might be to help prepare you for them. He or she can also give you an idea about what options might be available afterward, such as reconstructive surgery.

Neck dissection

If a salivary gland cancer is high grade, your surgeon might want to perform a neck dissection (surgery to remove lymph nodes in the neck area). If the lymph nodes in your neck are enlarged or if a PET scan suggests they may contain cancer, then a neck dissection may be done for more accurate staging and to remove all of the cancer.

There are many types of neck dissections, but their major purpose is to remove lymph nodes that might contain cancer. In doing this, the surgeon may need to remove connective, muscle, and nerve tissues, and blood vessels from one side of your neck.

Possible side effects: The general risks with a neck dissection are similar to those with any other type of surgery, including problems with anesthesia, bleeding, infections, and poor wound healing. After the surgery you may have ear numbness, weakness in raising your arm above your head, and weakness of the lower lip. These may get better with time. You can be helped by physical therapists who can teach you exercises to improve your neck and shoulder movement.

For more general information on surgery, see our document, Surgery.

Last Medical Review: 02/10/2009
Last Revised: 02/10/2009