University Otolaryngology Associates Philadelphia ENT
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Head and Neck

At University Otolaryngology Associates, our experienced physicians are specialists in the treatment of head and neck conditions including cancer of the head and neck, thyroid and para-thyroid disease, and management of salivary gland disease with minimally invasive techniques. We are skilled at aggressively treating all types and stages of head and neck cancer. We partner with other specialties including radiation and medical oncology, neurosurgeons, maxillofacial surgeons to provide you with coordinated care during your surgical or non surgical management of your treatment for head and neck disease. If you have a concern as to whether or not this is the appropriate practice for your medical condition, please do not hesitate to call our office and ask to speak with one of our clinical staff members.

Head and Neck Services:

Salivary Gland Disorders and Surgery

Saliva is a critical component to maintaining health of the Head and Neck. Without an appropriate amount and quality of saliva patients experience a variety of issues including: pain, dry mouth, dental issues, speech and swallowing disorders. Saliva is produced by three pairs of major salivary glands (Parotid, Submandibular, Sublingual) and thousands of minor salivary glands distributed throughout our mouth and throat. Disorders can include infections, stones, cysts or tumors.

Disorders of the Salivary Glands

Dry mouth

A dry mouth can be a very distressing condition often lasting for months or years. There are a wide variety of causes including infections, medications, rheumatologic disorder and side effects from cancer treatment including post-radiation xerostomia. A thorough evaluation is necessary. Often patients can be helped through a variety of agents both local in the mouth and systemic medications.

Salivary Gland Infections (sialadenitis)

Infections of a salivary gland will cause pain, tenderness and soft tissue swelling often accompanied by a foul, bitter taste in the mouth. Treatment can include antibiotics, oral rinses, gland massage and salivary stimulants. Rarely is surgery necessary.

Salivary Stones (sialalithiasis, salivary calculi)

Stones are typically located within the duct of the submandibular gland (85%) or the parotid gland (15%). Rarely are the sublingual glands involved. There is no specific cause although reduced salivary flow and reduced saliva production is often associated with stones. There can more readily developed in patients that are dehydrated. The stone can occlude the duct, blocking the drainage of saliva. Often the patient will experience a painful swelling of the gland (either in the cheek parotid or below the jaw submandibular) while eating which resolves quickly after the meal.

Evaluation with include an examination (often immediately after eating to examine the enlarged gland) and possibly an imaging study such as an MRI or CAT scan of the neck. Many times, the stone will pass on it’s own or can be removed through an office procedure with local anesthetic. Occasionally, the stone and possible the gland re-quires surgical removal.

Salivary Gland Tumors

There are a large variety of salivary gland tumors both benign and malignant. Most require surgical excision. Symptoms are typically limited to a palpable mass within the gland, often without any pain or tenderness. Any palpable mass in the neck lasting for more than two weeks should be evaluated.

Surgical Treatment for Disorders of the Salivary Gland

Surgical treatment is geared to the specific tumor. Removal of the the parotid or submandibular glands is accomplished in the operating room, under general anesthetic through a neck incision. The facial nerve (among others) is intimately involved with both of these glands and is at risk during the surgery. The physicians and University Otolaryngology use state of the art, neurophysiology monitoring techniques during surgery to minimize the risk of injury to the nerve and maximize the surgical benefit.

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