Salivary gland cysts or sialoceles can occur without any identifiable cause but usually are a complication of surgical or physical trauma to the major salivary glands (parotid, submandibular, or sublingual glands). These glandular structures are associated with a network of ductal systems that allow saliva to flow from the glands to the oral cavity. When trauma disrupts the continuity of this association between gland and duct, saliva can no longer flow into the oral cavity. This can lead to accumulation of saliva in the surrounding tissues or the gland itself, otherwise known as a sialocele.
A sialocele can form under the following circumstances:
- Physical trauma to glandular structures (e.g. accident, facial trauma)
- Surgical trauma to glandular structures (e.g. after removal of a salivary gland mass)
The best way to prevent formation of a sialocele after salivary gland surgery is to seek evaluation and treatment from an experienced salivary gland specialist.
Symptoms of Sialocele / Salivary Gland Cysts
Sialoceles are relatively benign but can be associated with the following complications:
- Pain due to accumulation of saliva and stretching/compression of surrounding tissues.
- Infection due to stagnation of salivary flow rate
- Interference with speech or chewing
- Undesirable cosmetic change
Diagnosis & Treatment
A qualified specialist emphasizes three critical aspects of salivary gland treatment:
- Precise removal of the affected salivary gland pathology
- Proper management of the remaining glandular tissue and associated ductal structures
- Close postoperative management and care to prevent complications such as sialocele
Through meticulous and experienced technique, salivary gland specialists are able to effectively treat disorders of the salivary gland while minimizing the complications associated with surgery, including sialocele formation. These physicians carefully dissect around the delicate structures that overlie and surround the salivary glands thereby preventing potentially serious complications such as facial paralysis, taste distortion, and disfigurement. Once resection of the affected salivary gland has been completed, proper management of the remaining glandular tissues is crucial to avoid sialocele formation.
An experienced specialist will ensure that after removing or altering the glandular structure, they identify and seal off any left over tributaries to the ductal system. This painstaking and advanced technique inhibits sialocele formation by preventing saliva from pooling within surrounding tissues of the cheek.
Proper postoperative care comprised of close followup and dietary modifications are also important factors in sialocele prevention. A salivary gland specialist will closely follow you and examine your surgical site for proper drain management, wound healing, scar formation, and infection prevention. Special compressive dressings and small drains are placed at the surgical site to promote proper fluid drainage as well as to close off any potential areas where saliva can accumulate. In addition to suppressing sialocele formation, this deters bacterial accumulation and infection. Dietary modifications are also prescribed to prevent the production of excess saliva during the healing phase.
Frequently Asked Questions
What is a sialocele?
A sialocele or salivary gland cyst is a fluid filled cavity formed by the disruption of normal salivary flow into the oral cavity. Trauma to the salivary system can disrupt normal flow causing saliva to pool in a major salivary gland or surrounding tissues. When the rate of saliva accumulation within these areas surpasses the body’s capacity to reabsorb it, a sialocele can form.
What types of trauma can lead to a sialocele?
- Surgical Trauma (e.g. following salivary gland surgery)
- Motor Vehicle Accident
- Sporting Injury
- Facial Injury
- Physical Altercation
Who is best suited to treat a sialocele?
It is recommended that all cases of suspected sialocele be evaluated and treated by a salivary gland specialist. These physicians are trained to recognize and treat rare and difficult cases not commonly seen by other providers. Sialoceles are associated with a high rate of recurrence and as such should be addressed with customized treatment protocols to minimize this risk.
If my sialocele is drained / aspirated, will it recur?
Sialoceles that are treated by drainage are associated with a high rate of recurrence. Because the mechanism which initially led to the formation of the sialocele has not been treated, recurrence of the lesion is very likely. Treatment by a qualified salivary gland specialist is highly recommended.
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