The salivary glands produce saliva to moisten the mouth, to help protect teeth from decay, and to digest food. The three major salivary glands are the parotid gland, submandibular gland, and sublingual glands. The parotid gland is the largest salivary gland and makes 25% of the saliva.
Parotid tumor is the most common salivary gland tumors. The majority of parotid tumors are benign, but they are also where most malignant tumors emerge. It usually presents as a lump or swelling in front of the ear. If you cannot link the swelling to an infection, you should get it investigated. This article will help you know more about parotid tumors and how to deal with it.
How does a parotid tumor present itself?
Parotid tumors usually present as a lump or swelling in the jaw area. They may or may not be present in this region for a long time. Usually, in their early stages, it is not possible to distinguish a benign tumor from a malignant one. One of the key differentiating symptoms of malignant growth is nerve involvement, facial pain, and paresthesia. Also, symptoms of duct blockage may accompany swelling.
What causes a parotid tumor?
The causes of parotid gland tumor are not precisely known. However, a genetic cause is thought likely. Oncogenes is a specific gene which control cell reproduction and the tumor suppressor genes control cell destruction. In the case of cancer, one or both of these cell-controlling gene types get mutated. The following factors can increase the risk of developing a parotid tumor –
- Radiation therapy for cancers in the head and neck increase the risk of developing salivary gland cancer later
- Older patients have a higher risk
- Genetic factors can increase risk
- Workplace exposure to substance such as nickel alloy dust and silica
What are the symptoms of a parotid tumor?
A person who has a parotid tumor may experience –
- Difficulty in opening mouth completely
- Weak facial muscles on one side of the face
- Swelling or lump around jaw, mouth, or neck area
- Noticeable difference in the shape of one side of the neck or face
- Part of the face feels numb
- The parotid gland is in constant pain
How is parotid tumor diagnosed?
The physician will ask you about your medical history and examine the sides of the face, the mouth, and the area around the jaw. If any lymph nodes seem to be enlarged, then it could be a sign of cancer. Muscle weakness or numbness in the face could indicate that cancer has spread to the nerves.
Imaging tests may be carried out to determine the location and spread to the nerves. A biopsy can be suggested to check for signs of cancer and differentiate between benign and malignant tumor. An OPG can be taken to rule out mandibular involvement.
How is parotid tumor treated?
Treatment for parotid gland tumor, as for many cancers, involves surgery, radiation therapy, chemotherapy, or a combination of these. The treatment process depends on several factors, including the patient’s overall health and the size, type, and the stage of cancer.
Surgery is the primary form of treatment for the parotid tumor. The whole gland may need to be removed, along with any nerves and ducts where cancer might have spread. If cancer has spread to another part of the mouth or body, then neck lymph node removal is also possible. If the tumor is small and has easy access, then it may be required to only remove cancerous and a small amount of surrounding tissue.
Radiation therapy directs high-powered energy particles or beams at the tumor to slow or destroy the cancer cells. It can be used after surgery or as a standalone option if the operation doesn’t suffice the purpose.
The treatment is usually given daily, five days a week for up to 7 weeks. Chemotherapy uses chemical-based drugs to kill cancer cells. It can only be used if the tumor is advanced enough that it has spread to other areas of the body. The patient takes the drugs either by mouth or intravenously to kill the cancerous cells.
What are the complications related to the parotid tumor?
Nerve damage may cause one side of the face to droop and the patient may have difficulty swallowing or talking. Reconstructive surgery and a speech therapist can help with restoring some of the lost functions. You may suffer from Gustatory sweating or Frey Syndrome where the nerves grow back in an unusual way. This lead to sweating over some areas of the face while chewing action. However, it can be treated with surgery or medications. Some adverse effects of radiation therapy include –
- Burning of the skin
- Nausea, vomiting
- Dry mouth, due to increased saliva production
- Throat and mouth sores
- Dry, sore throat
- Difficulty in swallowing
- Total or partial loss of taste
- Bone pain and damage
- Worsening of dental problems
- Damage to the thyroid gland
- Ringing or sensation of fullness in the ears
Common side effects of chemotherapy
- Reduced appetite, nausea, and vomiting
- Low white and red blood cell count, increasing the risk of infections and fatigue
- Low blood platelet count so that the body is easily bruised
- Hair loss
- Mouth sores
Some common complications of surgery
- Reactions to the anesthetics
- Slow wound healing
- Excessive bleeding
Take away message
Getting a diagnosis for a parotid gland tumor can be unsettling, but you should not let it affect your overall health. Prevention of parotid tumor is difficult as the exact cause is unknown. A healthy diet, regular exercise, and avoiding tobacco and alcohol can minimize the risk of getting a parotid gland tumor.
The prognosis for this tumor depends on the stage at which the cancer is diagnosed. Never neglect a consistent oral health routine such as brushing at least twice a day and flossing daily.