# Salivary gland tumour surgery > Removal of tumours of the parotid, submandibular and minor salivary glands, with careful protection of the facial nerve. Source: https://www.profgunterhafiz.com/services/salivary-gland-tumour-surgery/ Updated: 2026-10-09 Services · Plate V Removal of tumours of the parotid, submandibular and minor salivary glands, with careful protection of the facial nerve. Plate V https://www.profgunterhafiz.com/services/salivary-gland-tumour-surgery/ ## Anatomy · Plate V ### The salivary glands and the facial nerve, seen from the side 1. **Parotid gland**The largest salivary gland, in front of and below the ear. 2. **Facial nerve**The nerve that moves the face. Its branches run through the parotid gland, so they are found first and protected. 3. **Parotid duct**Carries saliva from the parotid gland to the inside of the cheek. 4. **Submandibular gland**Under the jaw; its duct opens in the floor of the mouth. 5. **Sublingual gland**The smallest of the three, under the tongue in the floor of the mouth. Simplified drawing, not to scale. Saliva is produced by three pairs of large glands (the parotid in front of the ear, the submandibular under the jaw and the sublingual under the tongue) and by hundreds of minor glands in the lining of the mouth and throat. Tumours can grow in any of them. Most are benign, some are malignant, and almost all are treated by surgery. ## What it is Salivary gland surgery removes a tumour together with the part of the gland around it. In the parotid gland this is a superficial or total parotidectomy, performed around the branches of the facial nerve, which passes through the gland and controls the muscles of facial expression. In the submandibular gland the whole gland is removed. Malignant tumours may also require removal of the lymph nodes of the neck and, in selected cases, radiotherapy afterwards. ## Who it is for Adults with a slowly growing lump in front of the ear, under the jaw or in the mouth; adults whose needle biopsy has shown a tumour; and people with a salivary gland cancer diagnosed elsewhere who need surgical treatment. ## Symptoms and diagnosis A slowly enlarging lump that does not hurt is the usual sign. Pain, rapid growth, numbness, weakness of the face, or a lump that is fixed to the skin or the deeper tissues raise concern for a malignant tumour. Diagnosis involves examination, ultrasound of the gland and neck, a fine-needle biopsy (cells taken with a thin needle) and MRI to show the extent of the tumour and its relation to the facial nerve. ## How the operation is done Parotid surgery is performed under general anaesthesia through an incision in front of the ear that continues into a skin crease of the neck, so that it heals discreetly. The main trunk of the facial nerve is found first, and the gland tissue with the tumour is lifted away from its branches; facial nerve monitoring may be used to confirm that the branches are working during the operation. Submandibular gland surgery uses an incision below the jaw, protecting the nerve to the lower lip and the nerves to the tongue. Minor salivary gland tumours in the palate or lip are removed through the mouth. The tissue goes to the pathologist, whose report confirms the type of tumour. ## Recovery Most people go home the day after surgery, with a small drain removed before discharge. Numbness of the earlobe and the skin of the cheek is common after parotid surgery and improves over months. A temporary weakness of part of the face may occur and usually recovers. Sweating of the cheek skin while eating (Frey’s syndrome) can appear later in some people and can be treated. Normal activities are resumed within one to two weeks. ## How Prof. Hafız works Salivary gland tumours are among the focus areas of Prof. Hafız’s practice, within his wider work in head and neck cancer surgery. Before the operation he explains the likely nature of the tumour, the course of the facial nerve and how it will be protected, and what the pathology report will mean for any further treatment. ## Signs to have examined - A lump in front of the ear, in the cheek, under the jaw or inside the mouth. - Numbness or weakness in part of the face. - Pain in the face that does not go away, or difficulty swallowing or opening the mouth wide. These signs are common and usually have another cause. They are a reason to see a doctor or an ear, nose and throat specialist, not a diagnosis. ## References 1. Salivary gland cancer: ESMO⁠–⁠European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up, ESMO Open (2022) — [doi:10.1016/j.esmoop.2022.100602](https://doi.org/10.1016/j.esmoop.2022.100602) 2. Management of Salivary Gland Malignancy: ASCO Guideline, Journal of Clinical Oncology (2021) — [doi:10.1200/JCO.21.00449](https://doi.org/10.1200/JCO.21.00449) 3. Classification of parotidectomies: a proposal of the European Salivary Gland Society, European Archives of Oto-Rhino-Laryngology (2016) — [doi:10.1007/s00405-016-3916-6](https://doi.org/10.1007/s00405-016-3916-6) 4. Salivary Gland Cancer Treatment (PDQ®)⁠–⁠Patient Version, National Cancer Institute (2025) — [cancer.gov](https://www.cancer.gov/types/head-and-neck/patient/adult/salivary-gland-treatment-pdq) · Accessed 2026-10-08 At a glance Who it is for Adults with a lump in a salivary gland, benign or malignant Anaesthesia General anaesthesia Hospital stay Usually one night First step A consultation with your ultrasound, needle biopsy result and any MRI [Write on WhatsApp](https://wa.me/905323748115?text=Hello%2C%20I%20would%20like%20to%20request%20an%20appointment%20with%20Prof.%20Dr.%20G%C3%BCnter%20Haf%C4%B1z.)[+90 532 374 81 15](tel:+905323748115) Related areas - [VINeck dissection and neck masses](https://www.profgunterhafiz.com/services/neck-dissection-neck-masses/) - [VIITransoral laser surgery](https://www.profgunterhafiz.com/services/transoral-laser-surgery/) - [VIIIMicrovascular reconstruction](https://www.profgunterhafiz.com/services/microvascular-reconstruction/) [All services](https://www.profgunterhafiz.com/services/) ## What to expect 1. Before - A consultation with your ultrasound, needle biopsy result and any MRI. - MRI shows the tumour's relation to the facial nerve. 2. On the day - General anaesthesia; for the parotid, an incision in front of the ear that runs into a skin crease of the neck. - The facial nerve is found first and its branches are protected; nerve monitoring may be used. 3. After - Usually home the next day, once the small drain is removed. - Numbness of the earlobe and the cheek is common and improves over months. - Normal activities within one to two weeks. ## Questions patients ask **Is a parotid lump usually cancer?** Most tumours of the parotid gland are benign, but they grow and can change over time, so they are usually removed. A needle biopsy and imaging give a good idea beforehand; the final answer comes from the pathologist. **What happens to the facial nerve?** The nerve that moves the face runs through the parotid gland. It is identified and protected during the operation, with nerve monitoring when appropriate. A temporary weakness can occur and usually recovers. **Will my mouth be dry afterwards?** No. The remaining salivary glands produce enough saliva; removing one gland does not cause a dry mouth. ## Talk it through with Prof. Hafız Consultations at Selenium Plaza, Beşiktaş, Monday to Saturday. Write on WhatsApp or call the practice. [Write on WhatsApp](https://wa.me/905323748115?text=Hello%2C%20I%20would%20like%20to%20request%20an%20appointment%20with%20Prof.%20Dr.%20G%C3%BCnter%20Haf%C4%B1z.)[+90 532 374 81 15](tel:+905323748115)