Salivary Gland Issues: Pain and Swelling in the Left Jaw - Otolaryngology

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It sounds like you are experiencing significant discomfort related to your left salivary gland, which has been swollen and painful for several months. Given your history of temporomandibular joint (TMJ) issues and the recent treatments you've undergone, it's understandable that you are feeling frustrated and concerned about your condition.

From what you've described, it seems that you initially developed pain in your right temporomandibular joint, which led to the use of a bite splint. This is a common treatment for TMJ disorders, as it helps to alleviate pressure on the joint and can reduce pain. However, the emergence of swelling and pain in your left salivary gland raises some important considerations.

Salivary gland issues can arise from a variety of causes, including infections, blockages (such as stones), or inflammation. In your case, the ultrasound indicated inflammation of the salivary gland, which is often referred to as sialadenitis. This condition can occur due to dehydration, reduced saliva flow, or bacterial infections. The fact that your symptoms improved with anti-inflammatory medications suggests that inflammation is a significant factor in your discomfort.

The absence of stones on the CT scan is a positive sign, as salivary stones can cause significant pain and swelling when they obstruct the duct. However, even in the absence of stones, chronic inflammation can lead to ongoing symptoms. The injections of anti-inflammatory medication into the gland are a reasonable approach to managing the inflammation, but it appears that the relief is temporary, and the underlying issue remains.

You mentioned that you experience a sensation of foreign body presence in the gland, particularly when consuming cold foods or drinks. This could be indicative of ongoing inflammation or sensitivity in the gland, which may not be fully resolved despite treatment. The fact that you have seen some improvement but still experience discomfort suggests that further evaluation may be necessary.

Regarding your consideration of surgical intervention, such as the removal of the affected salivary gland, this is typically considered a last resort. Surgery can carry risks, including damage to surrounding structures, changes in saliva production, and potential complications. Before proceeding with such a decision, it would be prudent to explore all non-invasive options and possibly seek a second opinion from an oral and maxillofacial surgeon or an ear, nose, and throat (ENT) specialist who has experience with salivary gland disorders.

In the meantime, here are some recommendations that may help alleviate your symptoms:
1. Stay Hydrated: Ensure you are drinking plenty of fluids to help maintain saliva flow. This can reduce the risk of blockages and promote gland health.

2. Warm Compresses: Applying warm compresses to the affected area may help reduce swelling and promote drainage.

3. Massage: Gentle massage of the area around the gland can sometimes help stimulate saliva flow and relieve discomfort.

4. Avoid Irritants: Try to avoid very hot, cold, or spicy foods that may exacerbate your symptoms.

5. Follow-Up Care: Continue to follow up with your healthcare provider to monitor your condition and discuss any changes in your symptoms.

6. Consider Stress Management: Since stress can exacerbate TMJ and salivary gland issues, exploring relaxation techniques such as mindfulness, yoga, or deep breathing exercises may be beneficial.

In conclusion, while your symptoms are concerning, there are various management strategies available. It is essential to work closely with your healthcare team to determine the best course of action for your specific situation. If your symptoms persist or worsen, do not hesitate to seek further evaluation and treatment options.