Hello, I’m Hakan Cıncık, MD. I am an ear, nose, throat, head and neck surgery specialist.
Today I want to talk to you about the diagnosis and treatment of salivary gland masses. Most salivary gland masses occur on our face and under our chin. The patient, who sees a swelling here, first comes to an ear, nose, throat, head, neck surgeon. Most of the diagnosis in these areas is done by needle biopsy. This is usually done with ultrasound. The location and shape of the masses determined with ultrasound. A small needle is inserted into the mass and a small piece is taken from the mass. And this piece is placed on a piece of glass and sent to the pathology doctor. According to the result of the pathology, treatment planning is made for the area of the mass.
If it is a benign mass, if it is in the cheek area, an operation called superficial parotidectomy is performed. The feature of this surgery is this: In this area, the facial nerve passes just below the mass. Therefore, the facial area should be monitored by nerve monitoring. It is necessary to know during surgery where we are, where we are in the tumor, and where the nerve is. As you know, since the facial nerve provides the movement of the whole face, if damage occurs to any of its branches, your lip might not move, the upper lip may not move, and your eye may not close. And the shape of the face may be distorted. Therefore, it is an important surgery. Even if the mass is benign, while the facial nerve is being monitored, the mass is cleaned and removed from above the facial nerve.
If the mass is malignant, it is necessary to be more careful. Both the mass is removed and the facial nerve is preserved. It is also necessary to remove the remaining salivary glands under the facial nerve. Because if the tumor is malignant, nothing should be left behind. Also, with neck dissection, lymph nodes in the neck should be included in this surgery. Because the salivary glands often spread to the neck lymph nodes on the same side. As a result of cleaning these lymph nodes, the patient will have a better recovery and prognosis. In the advanced stages of such tumors, radiotherapy and chemotherapy may be added to the treatment.
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