Managing Recurring Salivary Gland Cysts: What You Need to Know

Post-salivary gland cyst excision

Hello Doctor, I have undergone two surgeries for salivary gland cyst removal, but they keep recurring.
The first time, the cyst reappeared after the sutures fell out, and the second time, it developed before the sutures had even dissolved (although I found online that it might be a hard lump from the healing process, after 3 to 4 days of applying oral ointment, there has been no sign of it subsiding).
I would like to ask what I should do in this situation.
Is this frequency and likelihood of recurrence normal? The doctors at the hospital have told me both times that if it recurs again, I should come back, but if it keeps recurring like this, can I just ignore the cyst? (After all, it seems to grow back regardless of removal.) Thank you, Doctor, for taking the time to respond.

vane, 10~19 year old female. Ask Date: 2023/08/02

Dr. Ji Zhaoyun reply Otolaryngology

Hello, as mentioned in the text, if there are no instances of bites, scratches, or habits of consuming hard foods that could lead to the recurrence of a salivary gland cyst, but the cyst continues to recur, it may be worth discussing with your physician the possibility of removing a larger portion of the submandibular gland and performing a cystogastrostomy (if it is a cyst of the floor of the mouth) to reduce the recurrence rate.
Of course, the surgical risks will be slightly higher than that of a simple cyst excision, so it is advisable to discuss this further with your physician.

Reply Date: 2023/08/02

More Info

Managing recurring salivary gland cysts can be quite challenging, especially after undergoing multiple surgical interventions. Salivary gland cysts, often referred to as mucocele or ranula, can recur for various reasons, and understanding these factors is crucial for effective management.

Understanding Salivary Gland Cysts
Salivary gland cysts typically arise from the blockage or damage to the salivary ducts, leading to the accumulation of saliva. They can occur in any of the major salivary glands, including the parotid, submandibular, and sublingual glands. The most common type of cyst is a mucocele, which often results from trauma or obstruction of the duct, causing saliva to leak into the surrounding tissue.

Reasons for Recurrence
1. Incomplete Removal: One of the primary reasons for recurrence after surgical excision is incomplete removal of the cyst and its associated duct. If any part of the cyst wall or the duct remains, it can lead to the formation of a new cyst.

2. Underlying Conditions: Certain conditions, such as Sjögren's syndrome or other autoimmune disorders, can predispose individuals to the development of salivary gland cysts. If an underlying condition is not addressed, cysts may continue to recur.

3. Trauma: Repeated trauma to the area, whether from dental procedures, biting the cheek, or other factors, can lead to the formation of new cysts.

4. Infection: Infections in the salivary glands can also contribute to the formation of cysts. If the gland is inflamed or infected, it may not function properly, leading to blockage and cyst formation.

Management Strategies
1. Consultation with a Specialist: If you are experiencing recurrent cysts, it may be beneficial to seek a consultation with an oral and maxillofacial surgeon or an otolaryngologist who specializes in salivary gland disorders. They can provide a more thorough evaluation and may suggest advanced imaging studies, such as ultrasound or MRI, to assess the cyst and surrounding tissues.

2. Surgical Options: If cysts continue to recur, your doctor may recommend a more extensive surgical approach, such as sialadenectomy (removal of the affected gland) if the cysts are significantly impacting your quality of life. This is typically considered when conservative measures fail.

3. Observation: In some cases, if the cysts are asymptomatic and not causing significant discomfort or functional issues, a watchful waiting approach may be appropriate. However, this should be done under the guidance of a healthcare professional.

4. Medications: If inflammation or infection is present, your doctor may prescribe medications such as corticosteroids or antibiotics to manage symptoms and reduce the likelihood of cyst formation.

5. Home Care: Maintaining good oral hygiene and avoiding trauma to the area can help reduce the risk of recurrence. Additionally, warm compresses may provide relief if there is swelling or discomfort.

Conclusion
The recurrence of salivary gland cysts after surgical intervention is not uncommon, and the management of these cysts requires a tailored approach based on individual circumstances. While it may be tempting to ignore the cysts, especially if they are not causing significant issues, it is essential to maintain open communication with your healthcare provider. They can help you weigh the risks and benefits of further intervention versus observation. If you continue to experience discomfort or if the cysts are affecting your quality of life, further evaluation and treatment may be warranted.

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