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Two Years Ago I Had A Tumor Removed Off My

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Posted on Tue, 18 Aug 2020
Question: Two years ago I had a tumor removed off my parotid gland and since that time I have battled saliva (hyper salivation?) It started with saliva pocketing under the lining of cheek skin on corner of of upper lip and now it is across my upper lip, cheeks and front trough in front of lower teeth. Mouth fills up at night and impedes speech throughout the day. Very Very aggravating to deal with. Surgeon that performed surgery is baffled. Is it from nerve damage or maybe something happened to the tube from parotid gland?
doctor
Answered by Dr. Sumit Bhatti (4 hours later)
Brief Answer:
Sialocele / persistent active salivary fistula.

Detailed Answer:
Hi,

Thank you for your query.

1. From your description, this seems to be a spreading sialocele (pocket of saliva) with an active salivary fistula (communication of the salivary secretions under the skin) which is rare and seen in less than 5% patients post-surgery.

2. It will be better to aspirate and check the fluid to confirm that it is saliva. Imaging (an MRI Sialogram) will help.

3. In the initial period after surgery, the following is attempted:
(a) suction drains,
(b) repeated needle aspirations,
(c) pressure dressings,
(d) medications to reduce salivary secretions (which you have already tried).

4. Now your options are:
(a) A tympanic neurectomy,
(b) Sclerosant injections (such as hypertonic saline),
(c) Botox (botulinum toxin type A) injections,
(d) Low dose radiotherapy/ proton beam therapy,
(e) A total parotidectomy (completion parotidectomy).

I hope that I have answered your query.
If you have any further questions, I will be available to answer them.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Sumit Bhatti (44 minutes later)
Dr Bhatti,

Thank you for your follow up! Should I pursue a 2nd opinion with another ENT and share your insight or go with an oral surgeon?

Thank you,

XXXXXXX Morrow
doctor
Answered by Dr. Sumit Bhatti (19 hours later)
Brief Answer:
Details as discussed below:

Detailed Answer:
Hi,

Thank you for following up.

1. Take multiple opinions since a lot of time has elapsed since your surgery.

2. If you can share images, examination notes, reports and scans it will help in suggesting further management.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2662 Questions

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Two Years Ago I Had A Tumor Removed Off My

Brief Answer: Sialocele / persistent active salivary fistula. Detailed Answer: Hi, Thank you for your query. 1. From your description, this seems to be a spreading sialocele (pocket of saliva) with an active salivary fistula (communication of the salivary secretions under the skin) which is rare and seen in less than 5% patients post-surgery. 2. It will be better to aspirate and check the fluid to confirm that it is saliva. Imaging (an MRI Sialogram) will help. 3. In the initial period after surgery, the following is attempted: (a) suction drains, (b) repeated needle aspirations, (c) pressure dressings, (d) medications to reduce salivary secretions (which you have already tried). 4. Now your options are: (a) A tympanic neurectomy, (b) Sclerosant injections (such as hypertonic saline), (c) Botox (botulinum toxin type A) injections, (d) Low dose radiotherapy/ proton beam therapy, (e) A total parotidectomy (completion parotidectomy). I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards