Choosing the Right Expert for Salivary Gland Surgery in Auckland and Understanding the Risks and Recovery

John Chaplin
May 27
4 min read

Salivary gland surgery is a delicate procedure that requires expert care and precision. Whether you face a tumour, chronic infection, or obstruction, selecting the right surgeon in Auckland can make a significant difference in your outcome. This post explains why surgery might be necessary, the common risks involved, the types of tumours that affect salivary glands, and what to expect during recovery. Understanding these factors will help you make informed decisions and prepare for the journey ahead.

A right parotid gland tumour being planned for surgical removal

Why Salivary Gland Surgery May Be Needed

Salivary glands produce saliva, which aids digestion and keeps the mouth moist. Surgery becomes necessary when these glands develop problems that cannot be managed with medication or less invasive treatments. The glands are either paired major glands in the face and neck such as the parotid, submandibular or sublingual glands or they are copious minor salivary glands through the mucosa (lining) of the mouth, throat and even the nasal cavity. The parotid glands are the most commonly affected by tumours (usually benign) whereas the submandibular is most commonly affected by stones and obstruction. Common reasons for surgery include:

Tumours: Both benign and malignant tumours can develop in salivary glands. Surgery aims to remove these growths completely.
Chronic infections or abscesses: Persistent infections that do not respond to antibiotics may require surgical drainage or gland removal.
Obstructions: Stones or strictures blocking saliva flow can cause swelling and pain, sometimes needing surgery.
Cysts or other growths: Non-cancerous cysts may also require removal if they cause discomfort or risk infection.

Choosing a surgeon with experience in salivary gland conditions ensures the best chance of successful treatment and minimal complications.

Understanding the Risks of Salivary Gland Surgery

Like any surgery, salivary gland procedures carry risks. Knowing these helps you weigh the benefits and prepare for possible outcomes.

Facial Nerve Injury

The facial nerve runs close to 2 of the major salivary glands, especially the parotid gland. Damage to this nerve can cause weakness or paralysis of facial muscles. Surgeons in Auckland skilled in salivary gland surgery like Dr John Chaplin at Mauranui Clinic in Epsom, use careful techniques to identify and protect this nerve during the operation. Temporary weakness is more common than permanent damage, but even that remains a low risk in highly experienced hands. If the tumour is malignant it is possible the nerve is involved and it may need to be sacrificed. If this is necessary there are techniques employed to improve facial appearance and function

Salivary Leak or Fistula

After surgery, saliva may leak from the gland or incision site, forming a fistula. This can delay healing and increase infection risk. Surgeons often place drains and provide wound care instructions to minimise this complication. It is uncommon

Haematoma

A haematoma is a collection of blood under the skin that can cause swelling and pain. It may require drainage if large. Surgeons take care to control bleeding during the procedure and monitor patients closely afterward.

Frey’s Syndrome

This condition causes sweating and flushing in the cheek area during eating. It happens when nerve fibers that normally stimulate saliva mistakenly connect to sweat glands after surgery. Frey’s syndrome can develop weeks or months post-operation. Treatments include topical or systemic medications or botox injections to reduce symptoms.

Common Tumours of the Salivary Glands

Salivary gland tumours vary widely in type and behaviour. Understanding these helps clarify why surgery is often the best option.

Pleomorphic adenoma: The most common benign tumour, slow-growing but can become large or recur if not fully removed.
Warthin’s tumour: Another benign tumour, often found in older adults, usually painless.
Metastatic cutaneous SCC or melanoma: In NZ the commonest malignant tumour in the parotid gland is metastatic skin cancer from the face scalp and neck that has spread to intra-parotid lymph nodes or level one nodes associated with the submandibular gland
Mucoepidermoid carcinoma: A common malignant tumour with variable aggressiveness, requiring complete removal and sometimes additional therapy.
Adenoid cystic carcinoma: A slow-growing but aggressive cancer that can invade nerves and tissues.
Other rare tumours: Including acinic cell carcinoma and carcinoma ex pleomorphic adenoma.

A biopsy or imaging study usually guides diagnosis before surgery. Dr Chaplin performs office based ultrasound and ultrasound guided FNA biopsy at the consultation to rapidly expedite diagnosis and allow for early treatment decisions

What to Expect During Recovery

Recovery from salivary gland surgery depends on the extent of the procedure and individual health factors. Here is a general overview:

Hospital stay: Most patients stay 1 to 2 days after surgery for monitoring.
Pain and swelling: Mild to moderate pain is common and managed with medication. Swelling usually peaks within 48 hours and then subsides.
Wound care: Keeping the incision clean and dry is essential. Your surgeon will provide detailed instructions.
Diet: Soft foods and plenty of fluids help during the first week.
Activity: Rest is important initially, but gentle movement helps prevent stiffness.
Follow-up visits: Sutures are usually removed at one week and the pathology will be discussed
Facial exercises: In the rare circumstance that facial nerve weakness occurs, exercises may aid recovery.

Most patients return to normal activities within 2 to 4 weeks, but full recovery can take longer if complications arise.

Choosing the Right Surgeon in Auckland

Selecting a surgeon with specific expertise in salivary gland surgery is crucial. Dr John Chaplin at Mauranui Clinic in Epsom, Auckland has expert training and many years of experience in performing surgery on parotid and salivary gland tumours, cancers and inflammatory concerns

Specialisation in head and neck surgery or ENT with a focus on salivary gland disorders.
Experience with both benign and malignant tumours.
Good patient reviews and clear communication.
Access to multidisciplinary teams for comprehensive care if cancer is involved.
Use of advanced imaging and surgical techniques to reduce risks.