Diseases Of The Nose Throat And Ear

DISEASES OF THE SALIVARY GLANDS

SYMPTOMS. The main symptom is swelling, but pain may be present. There
may be dysphagia in tumours involving the palate, the tongue or the
pharyngeal walls, while a tumour of the hard palate may cause discomfort in
wearing a previously well-fitting dental plate. Involvement of the facial nerve
suggests malignancy.

TREATMENT. Biopsy is generally not advised because it leads to leak of
tumour cells, and therefore surgical excision is advised at the outset. The
principal danger of excision is that of damaging the facial nerve, but modern
techniques are such that most tumours may be removed completely without
injury. The tumour must not be shelled out from its capsule because of the
frequent extensions. Therefore wide removal is necessary, including normal
parotid tissue. In palatal tumours palatectomy or maxillectomy may be
required. The common tumours are not radiosensitive, but irradiation may
occasionally be used after surgery, especially with malignant growths.

PROGNOSIS. With advances in surgical techniques, recurrences are less
common, and only some 2 per cent of all tumours recur.

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