When a salavary gland produces stones do you have to remove the whole gland? What are the risks if you do nothing?
Reply: ---------------------------
It depends on which salivary gland is involved, how big the stone is, where in the affected gland the stone is located, and whether or not the problem is a recurrent one.
In my experience, most isolated stones in a saliva gland occur in the submaxillary gland located under the chin. Usually the problem is an isolated occurence and the stone is not located in the gland, but rather in the duct of the gland. This will cause fluctuating and uncomfortable (sometimes painful) enlargement of the gland whenever one eats with shrinkage of the gland between meals. In this situation the duct can simply be incised under local anesthesia and the stone then removed. This can be performed quite simply in the office and no sutures are necessary. The area will heal within 24-48 hours with minimal if any pain.
Stones that are located in the substance of the gland itself usually require complete removal of the gland. Recurrent stone formation in the same gland also usually represents an indication to remove the gland. When stones form in the parotid gland (located in front and below the ear)this is a more difficult and complicated matter. In some instances, multiple stones in a gland or stones in multiple glands, may be a sign of systemic disease conditions and warrants a more involved evaluation.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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