Salivary Gland Surgery
What are salivary glands diseases and how to treat them through ENT head and neck surgery
What are salivary glands diseases and how to treat them through ENT head and neck surgery
Salivary glands are multiple small organs whose role is to produce saliva, which serves to moisten the mouth, help digestion and contribute to oral health.
There are different types of salivary glands:
• 2 parotid glands, located at the level of cheeks, just before the ears.
• 2 submandibular glands (submaxillary), located below the mandible, laterally.
• 2 sublingual glands, both under the chin.
The pathology of the salivary glands is extremely varied but can be schematically divided into two broad categories, tumour pathology (benign and malignant tumours) and non-tumour pathology most often related to the presence of stones (lithiasis) in the evacuation canals of the salivary glands.
The glands that are primarily concerned with surgery are the parotid and submaxillary glandes.
The parotid gland is a large gland located before the ear. It is crossed by the facial nerve, which provides the motor control of all the muscles of the face. This nerve exits from the ear and then divides within the gland, into two large branches, then into multiple branches. Each branch must be preserved, at the risk of paralyzing the muscle it innervates, that is to say, making the face motionless and inexpressive. For this reason, this surgery is very delicate. The incision is large to allow to easily find the origin of the nerve which is deeply imbedded before the ear, but hidden in a fold of the neck.
The submaxillary gland (submandibular) is a salivary gland located under the mandible (jaw). It is surrounded by different nerves, which must be preserved. The most exposed is a branch of the facial nerve, which ensures the tonicity of half of the lower lip and crosses the gland in 50% of cases. This nerve is so fine that it is very difficult to find. To preserve it more surely, the skin incision must be superficial. The other nerves (hypoglossal nerve, which ensures the movement of the tongue, and the lingual nerve, which ensures the sensitivity of the floor of the mouth and the tongue), are wider and easy to spot.
To increase the safety of this intervention, Dr. HERVE uses a nerve stimulator, called NIM (Nim3-Response 3.0, by Medtronic), which can identify the nervous branches and verify their good function.
Dr. Stéphane Hervé is an ENT surgeon and head and neck specialist who graduated from some of the best universities in France. He has more than 20 years of experience and solid training, acquired in hospitals and clinics in France, renowned for their infrastructures, technical staff and equipment in the field of salivary gland surgery.
