Salivary glands are structures responsible for producing saliva, a fluid essential for digestion, lubrication of the oral cavity, dental health, and protection against infections. There are three main pairs of major salivary glands—parotid, submandibular, and sublingual—as well as hundreds of minor salivary glands distributed throughout the lips, cheeks, palate, and tongue.
Their anatomy is complex: the parotid glands are located in front of the ear and surround the facial nerve; the submandibular glands lie beneath the lower jaw; and the sublingual glands sit on the floor of the mouth. This close relationship with highly relevant neural and vascular structures (facial nerve, hypoglossal nerve, facial and lingual vessels) means that surgical management requires great precision and experience.
Salivary gland disorders can be grouped into three broad categories:
Salivary glands can become inflamed due to viral infections (such as mumps), bacterial infections, or autoimmune diseases such as Sjögren’s syndrome. These inflammatory conditions can cause pain, swelling, and difficulty chewing or opening the mouth. Initial treatment is usually medical, including hydration, antibiotics, anti-inflammatory medications, and management of the underlying cause.
Conventional or minimally invasive surgical intervention is rarely required for acute management of an infectious or inflammatory episode; however, surgery may be necessary later when a structural cause is identified, such as salivary duct obstruction or persistent sialolithiasis.
Sialolithiasis (the formation of salivary stones) primarily affects the submandibular gland due to the viscosity of its saliva and the upward course of its excretory duct. Patients typically experience pain and gland swelling during meals, which then gradually decreases. Over time, episodes become more frequent and may be associated with recurrent infections.
Diagnosis is made with ultrasound or CT scan, which can visualize the stone and assess the condition of the gland. Treatment is aimed at removing the obstructive cause and preserving gland function.
Treatment options include:
Salivary gland neoplasms comprise a broad and heterogeneous group of tumors that may be benign or malignant. Their diagnosis and treatment require precise evaluation, as they develop in close relationship with neural and vascular structures of the neck and face.
The parotid gland is the major salivary gland most frequently affected by tumors. Its key anatomical feature is that the facial nerve runs through it, dividing the gland into superficial and deep lobes. This nerve controls the muscles of facial expression.
During parotid surgery, identification, preservation, and monitoring of the facial nerve are critical steps. The extent of the procedure depends on the diagnosis (benign or malignant), the size, location, and relationship to the nerve. For this reason, these surgeries should be performed by highly experienced teams with access to advanced technologies such as intraoperative neuro-monitoring, real-time pathology, and high-resolution imaging.
In certain circumstances, in malignant tumors that involve the nerve, it may be necessary to resect a portion of the nerve to achieve complete oncologic resection. In such cases, it is essential to have micro-surgical reconstruction options and complex facial reanimation techniques available.
The collaboration between Dr. Alejandro Yanzon and Dr. Larrañaga—specialist in facial reanimation and microsurgery—makes it possible to offer patients every option for functional and aesthetic reconstruction without compromising the primary oncologic goal of surgery.
Benign tumors account for approximately 70–80% of salivary gland neoplasms. The most common is pleomorphic adenoma, which presents as a painless, slow-growing mass. Although benign, it can transform into a malignancy if left untreated. Other benign tumors include Warthin tumor, oncocytoma, and basal cell adenoma.
Treatment is surgical and consists of complete resection of the lesion while preserving the facial nerve. In the parotid gland, a superficial or total parotidectomy is performed depending on the location of the tumor.
Malignant salivary gland tumors are less common but highly complex. Among the most frequent are mucoepidermoid carcinoma, adenoid cystic carcinoma, carcinoma ex pleomorphic adenoma, and adenocarcinoma. Their behavior can range from slow-growing forms to highly aggressive lesions.
Diagnosis is based on imaging studies (ultrasound, MRI) and fine-needle aspiration (FNA). In the operating room, intraoperative frozen-section biopsy can be key to determining the extent of the procedure.
The main treatment is surgical and may range from a superficial parotidectomy to a wider resection with neck dissection. In high-grade tumors or those with a high risk of recurrence, adjuvant radiotherapy is indicated.
Treating salivary gland disorders—particularly tumor-related conditions—requires experience, planning, and a multidisciplinary approach. Dr. Alejandro Yanzon and his team perform a high annual volume of head and neck surgeries, including complex salivary gland procedures and microsurgical reconstructions. This experience makes it possible to deliver safe oncologic outcomes with excellent functional and aesthetic preservation.
Comprehensive management of these conditions requires collaboration across multiple specialties. Dr. Yanzon’s team includes specialists in Head and Neck Surgery, Diagnostic Imaging, Pathology, Medical Oncology, Radiation Oncology, Rehabilitation, and Facial Reanimation, as well as specialized anesthesiologists and speech therapists.
This approach makes it possible to offer safe, personalized, evidence-based treatments—prioritizing both oncologic cure and the patient’s facial function and aesthetics.