Swollen Salivary Gland

Dear Dr. B: Left side of my face is swollen. MRI shows swelling of the parotid salivary gland. What are the causes of swelling of the parotid gland?

Answer: Saliva is produced by several salivary glands in and around our mouth. The major salivary glands are parotid glands (in front of the ears), submandibular glands (under the jaws) and sublingual glands (under the tongue).

There are several minor salivary glands located in different areas of our mouth. The function of saliva is to lubricate our mouth, initiate digestion (it has an enzyme) and help protect our teeth.

There are several reasons why the salivary gland may become enlarged.

The ducts draining the parotid or submandibular gland may get blocked by stone formation or scarring (stricture). The gland swells up and becomes painful during eating when the saliva is trying to flow through the duct. A blocked gland can easily become infected. This causes more swelling and pain. If this remains untreated then it becomes abscessed requiring surgery.

In children, the salivary gland may enlarge due to mumps.
Painless enlargement of the salivary gland usually indicates tumor. But not necessarily malignant tumor. Most common tumors of the salivary gland are benign in nature. Tumors rarely involve more than one gland.

Malignant tumors of the parotid can be painful and may cause paralysis of one side of the face. The facial nerve passes through the parotid gland and gets trapped in the malignant process. This causes weakness on one side of the face.

Salivary gland enlargement also occurs in autoimmune diseases such as HIV and Sjögren’s syndrome where the body’s immune system attacks the salivary glands causing significant inflammation. Dry mouth or dry eyes are common. This may occur with other systemic diseases such as rheumatoid arthritis, diabetes and among alcoholics.

Diagnosis of salivary gland disease depends on the careful taking of history, a physical examination, and laboratory tests, plain and dye x-rays, CT scan and/or MRI.

Not all salivary gland swellings require major surgical procedure. In some cases medical treatment is a good option. Your specialist can discuss the various options available to you once a diagnosis has been made.

Thought for the week:

“Appetite grows by eating.” – Francois Rabelais

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