Salivary glands: Treating stones and tumors

This content is sponsored by MedStar Washington Hospital Center

You may pay little mind to the salivary glands in your mouth. The glands produce saliva, which helps kill germs in the mouth and allows you to easier chew and swallow.

But while the glands are small, big health issues can arise if problems with them are ignored, said Dr. Matthew Pierce, an otolaryngologist at MedStar Washington Hospital Center.

Everyone has four major salivary glands as well as multiple minor salivary glands throughout the mouth. Sometimes stones or tumors develop and block the flow of saliva from these glands, Dr. Pierce said. While the vast majority of salivary gland tumors are not cancerous, some continue to enlarge and can develop into cancer if left untreated, he added.

“We don’t really know what causes [stones] in certain people,” Dr. Pierce said, adding that people who are dehydrated are more prone to developing stones. Also, those who have high calcium levels, have smoked and have had previous radiation or radioactive iodine treatment for thyroid cancer also are vulnerable.

It’s difficult to reduce the risk of salivary gland tumors or stones, he said. However, “one of best things you can do is stay well hydrated.”

Symptoms of a salivary gland disorder can manifest differently depending on the case. Some may notice swelling in the cheek and jawbone. Some stones can present with recurring swelling and pain that resolves and returns. Some patients may not see any noticeable symptoms, Dr. Pierce said.

“The majority of tumors of the salivary gland actually don’t cause much symptoms and they are actually quite small and often they are found incidentally when getting imaging for other issues,” Dr. Pierce said.

Average salivary stones and tumors are the size of a marble, but some can be as large as a golf ball. Salivary gland tumors can occur in patients of any age, but they are found most commonly in patients in 40s, 50s, 60s and older; certain tumors are seen more common in the elderly, he said.

The vast majority of tumors in salivary gland are benign, but if you don’t treat them they can enlarge and become cancerous.

There is not a medication to treat cancers or tumors of salivary glands, Dr. Pierce said, because typically they are treated with surgery upfront. For patients who have dry mouth, there are some mouthwash products that doctors can prescribe and other medications that can help with saliva production.

As far as surgical options, doctors often perform a minimally invasive procedure called a sialendoscopy. During the procedure, scopes with instruments fit into the larger salivary glands and can examine abnormalities and remove stones.

Patients who have the procedure for a stricture or stone usually can go home the same day. A hospital stay is usually required if there is an open procedure to remove the gland, which requires anesthesia and a small incision.

Advancements in treatments for salivary gland issues allow MedStar Washington Hospital Center to care for a wide range of patients, Dr. Pierce said.

“We have a very unique capacity to collaborate with our colleagues in other specialties. And we treat everything from the most simple to the most complex salivary gland diseases and by coming to one center where you get very comprehensive type of care, you avoid delays in care as well as you get the most state-of-the-art treatment for whatever salivary gland disease you may have.”

Read more and listen to a podcast from Dr. Pierce here.

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