Robotic Parotidectomy surgery in Bangalore

A parotidectomy is a surgical procedure to remove the parotid gland tumour. The parotid gland is the largest salivary gland located in front of the ear.

Pleomorphic adenoma is the most common salivary gland tumour. It predominantly affects the superficial lobe of the parotid gland. It is a benign tumour. But over time, it can turn cancerous. It is also known as a mixed tumour because it consists of a combination of different cell types. Surgery is needed as this can turn into cancer and also it can be damaging when it grows.

The routine surgery leaves the patient with a scar in front of the ear. However, today we can perform robotic parotidectomy.

Dr Sandeep Nayak, a well-known doctor for parotidectomy in Bangalore, says that “robotic parotidectomy uses a remote access approach to make the scar of surgery invisible. A robotic platform also gives magnification, unmatched vision clarity, and precision.”

Dr Sandeep Nayak is among the preferred surgical oncologists for people seeking parotidectomy surgery in Bangalore.

In this article, we will explore the types of salivary glands, salivary gland tumours, their causes, treatment options and more.

First, let’s know,

Salivary glands are a group of glands in the human body that produce saliva. These glands are primarily responsible for the production and secretion of saliva.

There are three major salivary glands:

The parotid glands – These are large salivary glands in front of the ear.

The sublingual glands – The smallest glands below the sides of the tongue.

The submandibular glands – These are smaller and are located under the jaw.

The parotid glands are ducts located next to the upper second molar. They secrete saliva into the mouth to lubricate and digest the food.

Each parotid gland comprises two parts:

• Superficial lobe
• Deep lobe

A tumor occurs when there is abnormal cell growth in any part of your body. Your lips, mouth, cheeks, and throat all contain many salivary glands and all of these glands are capable of developing tumors.

The most common tumor of the salivary gland is pleomorphic adenoma which can develop in several different types of glandular tissues, but the most frequently affected salivary glands are the parotid glands. These tumors are usually benign, but in rare cases, they can become cancerous.

Tumors of the salivary glands can take many distinct forms. Doctors categorize salivary gland tumors depending on the types of cells present in the tumors.

Benign or non-cancerous tumors of the salivary glands include:

• Basal cell adenoma – usually occurs in women over 50
• Canalicular adenoma – rare and unique salivary gland tumor
• Oncocytoma – usually affects the elderly in their 60s and above
• Pleomorphic adenoma – the most common tumor of the salivary gland
• Warthin tumor – slow-growing common tumor

Cancerous (malignant) tumors of the salivary glands include:

• Acinic cell carcinoma – usually occurs in people aged over 50
• Adenocarcinoma – occurs in glands that release bodily fluids such as saliva, mucus, etc
• Adenoid cystic carcinoma – a rare type of cancer that usually occurs in the head and neck
• Clear cell carcinoma- shows a clear cytoplasm when stained with hematoxylin (H) and eosin (E)
• Malignant mixed tumor – cancer that develops in a pre-existing benign tumor
• Mucoepidermoid carcinoma – contains 3 cellular elements
• Oncocytic carcinoma – extremely rare occurrence in salivary glands
• Polymorphous low-grade adenocarcinoma – rare and usually occurs in the roof of the mouth
• Salivary duct carcinoma – rare but highly aggressive malignant tumor
• Squamous cell carcinoma – usually occurs in older men

Your doctor can choose the most appropriate course of therapy for you by taking into account the sort of salivary gland tumor you have.

If the tumor is cancerous, the stage is based on size and location.

They are as follows:

Stage I: The tumors are tiny (not more than 2 cm in diameter) and has not spread to other parts of your body.

Stage II: The tumors are slightly larger (2 – 4 cm) but have not spread from the original gland.

Stage III: The tumors have migrated from the original gland and may have reached the lymph nodes in the neck.

Stage IV: The tumors have reached the other body parts.

Additionally, doctors will assign salivary gland tumors a grade ranging from 1 to 3 based on how quickly the cancer cells are growing.

Grade 1: This malignancy is low-grade. It has a high prognosis for recovery. It is slow growing and does not appear different from the normal cells.

Grade 2: The pace of cancer growth is moderately fast.

Grade 3: The cancer type is aggressive

The primary treatment for pleomorphic adenoma or any parotid gland tumor is surgical removal, especially for those with early-stage, slower-growing tumors. It aims to completely excise the tumor.  As there are multiple salivary glands removal of one or 2 glands does not affect normal secretion of saliva.

In most cases, surgeons achieve this through a partial or superficial parotidectomy. It involves removing the tumor and a portion of the affected gland. In some instances, a total parotidectomy may be necessary if the tumor is extensive.

Dr Sandeep Nayak, an eminent robotic surgical oncologist in India, frequently performs robotic parotidectomy on patients seeking parotidectomy.

Robotic parotidectomy is a remote access procedure. It involves small incisions and a camera to guide the surgeon. This technique allows for more precise gland removal and quicker recovery.

Parotidectomy is challenging due to several anatomic structures close to the gland. These structures include the facial nerve, external carotid artery, and internal jugular vein. The facial nerve is at particular risk during parotidectomy, as it courses through the gland and is vulnerable to injury.

The surgeon may need to remove the entire or just a portion of the salivary gland. They might remove the lymph nodes and reconstruct the face and neck.

Overall, pleomorphic adenoma has a good prognosis, with a low recurrence rate after complete surgical removal. However, there is a small risk of recurrence or transformation into a malignant tumor called carcinoma ex-pleomorphic adenoma, especially if the tumor is incompletely excised or has certain histological features.

If you suspect you have a pleomorphic adenoma or have concerns about a salivary gland tumor, it is essential to consult with a healthcare professional, who can evaluate your symptoms, order the necessary tests, and provide appropriate treatment recommendations.

Except in cases where the cancer is more advanced, radiation and chemotherapy are not the first-line treatments.

Following surgery, the patient might have radiation to eradicate traces of any remaining cancer cells.

Dr Sandeep Nayak says that although there is no way to prevent parotid or salivary gland cancer of any kind, as the cause of these cancers is not known. It is best to take medical help when you notice any abnormal swelling around face.

The common symptoms of parotid gland tumors include:

• Swelling or lump in your mouth, on your jaw, or neck is the only early symptom
• Reduced muscular strength on one side of the face
• Numbness in a part of the face
• Constant pain in the affected area
• Difficulty in yawning or opening the mouth wide

Let’s see some signs and symptoms of pleomorphic adenoma:

The symptoms may include a painless, slow-growing mass or lump in the salivary gland area, usually near the jawline or below the ear.

The tumor is typically movable, firm, and well-defined. Occasionally, it may cause pain or discomfort, especially if it grows large or presses on nearby structures.

Salivary cancers can strike people of practically any age. But they become more prevalent as people age. Studies have shown that the typical age of people when they are diagnosed is 55.

Most benign (non-cancerous) salivary gland tumors in children do not extend to other tissues.

Children’s salivary gland tumors are more frequently malignant than those in adults. However, children with salivary gland cancer typically have a good prognosis.

Pleomorphic adenoma, the most common salivary gland tumour, can affect people of any age. But it most frequently affects people between the ages of 30 and 60. The incidence of pleomorphic adenoma is higher in females, at a ratio of 2:1 than in males.

Robotic surgery has emerged as a promising technique for adequate parotidectomy. Robotic surgery allows the surgeon to operate with greater precision and control while providing improved optics and enhanced ergonomics.

Robotic parotidectomy is a safe and effective option for treating parotid tumors. It offers the potential for improved outcomes and reduced complications.

If you or a loved one suspects a salivary gland tumor, please do not delay seeking medical treatment. If you are considering parotidectomy surgery in Bangalore, do not hesitate to consult the highly experienced surgical oncologist.