Salivary Gland Surgery & Microsurgical Precision: Safety, Function, and Aesthetics
The major salivary glands (the parotid and submandibular glands) play a key role in oral lubrication and digestion. When they are affected by tumors (benign or malignant), stones (salivary lithiasis), or recurrent chronic inflammation, targeted surgical treatment becomes essential.
Salivary gland surgery demands exceptional anatomical mastery, due to the immediate proximity of major nerve structures — notably the facial nerve and the motor branches of the tongue. Using discreet, aesthetically placed incisions, optical magnification, and real-time intraoperative nerve monitoring, every procedure is carried out with strict respect for the functional and aesthetic integrity of the face.
Pre-Operative Assessment & Precision Imaging
The success and safety of the procedure rely on a rigorous three-dimensional analysis of the lesion and its surrounding anatomy:
- Advanced imaging (MRI & ultrasound / CBCT): Precise delineation of the lesion's margins, its position relative to the different glandular lobes, and mapping of the vascular and ductal relationships.
- Cyto-histological correlation: Biopsy or fine-needle aspiration is incorporated when necessary, to tailor the surgical approach to the exact histological type of the condition.
- Dr Yousefpour's clinical approach: A personalized analysis of the surgical approach and preparation of micro-anatomical mapping, to preserve motor nerve function and optimize the final scar.
Our Procedures: Indications, Expertise, Recovery & Precautions
1. Parotid Gland Surgery (Parotidectomy)
Located in front of and below the ear, the parotid gland is crossed by the facial nerve, which controls movement in all the muscles of facial expression. The procedure involves partial removal (superficial or partial parotidectomy) or total removal of the gland, depending on the extent and nature of the lesion.
- Indications: Benign parotid tumors (pleomorphic adenoma, Warthin's tumor / cystadenolymphoma), malignant tumors, chronic sialadenitis, or parotid cysts.
- Dr Yousefpour's specific expertise: Systematic use of continuous facial nerve monitoring (NIM neuromonitoring), combined with magnification under a surgical microscope, to individually identify, dissect, and preserve each motor nerve branch. A facelift-style incision (a modified Redon approach or peri-auricular incision) is used to perfectly hide the scar within natural skin folds and the hairline, along with filling of the glandular defect to prevent a post-operative hollow in the cheek.
- Recovery: Moderate swelling of the parotid region for 1 to 2 weeks. A suction drain is often placed and removed after 24 to 48 hours. Numbness of the earlobe is common and temporary, lasting a few months. Return to normal activities after 10 to 14 days.
- Possible complications: Temporary facial weakness due to delicate nerve handling (spontaneous recovery in the vast majority of cases within weeks to months), localized hematoma or seroma, temporary salivary fistula, Frey's syndrome (skin sweating during chewing — rare and treatable).
2. Submandibular Gland Removal (Submandibulectomy)
Located under the edge of the lower jaw, the submandibular gland is surrounded by the marginal branch of the facial nerve (which lowers the corner of the mouth), the lingual nerve (sensation and taste for half of the tongue), and the hypoglossal nerve (tongue mobility).
- Indications: Large obstructive salivary stones (not removable by endoscopy/sialendoscopy), recurrent chronic infections (sialadenitis), and benign or malignant tumors of the submandibular space.
- Dr Yousefpour's specific expertise: A minimally invasive neck incision positioned precisely within a natural neck crease (at least 2 to 3 cm below the jawline) to conceal the scar. Fine sub-capsular dissection and rigorous hemostatic control, ensuring absolute protection of the marginal branch of the facial nerve and the adjacent lingual nerve during release of the excretory duct (Wharton's duct).
- Recovery: Moderate discomfort when swallowing during the first few days, well controlled with pain relievers. Submandibular swelling for 7 to 10 days. Sutures or resorbable stitches removed according to protocol. Return to activities after 7 to 10 days.
- Possible complications: Neck hematoma, temporary weakness of the muscle that lowers the corner of the mouth (a temporary asymmetric smile), paresthesia or a temporary change in tongue sensation, minor dry mouth (the other salivary glands fully compensate for secretion).
Informed Consent: Clarity & Trust
Any procedure on the salivary glands requires complete, transparent information beforehand, so that you can approach treatment with full peace of mind.
During your dedicated pre-operative consultation:
- We review your imaging together (ultrasound, MRI, CBCT) to visualize the lesion and its surrounding anatomy.
- The surgical procedure, the aesthetic surgical approach, and the nerve-safety technologies (monitoring) are explained to you step by step.
- The typical post-operative course, follow-up, and risks specific to the glandular and nerve anatomy are discussed openly.
A personalized information and informed consent form is provided to you, giving you time to reflect calmly before any surgical decision.