Post-Surgery Discomfort After Salivary Gland Cyst Removal: What to Do?

Postoperative discomfort after salivary gland cyst surgery?

Hello, doctor.
In December of last year, I had a salivary gland cyst at the junction of my lower lip and gum.
I received treatment at Kaohsiung Medical University and underwent an outpatient laser surgery.
After the surgery, due to issues with scar discomfort, I returned for a follow-up appointment where the doctor suggested using laser treatment to thin the scar.
This was done on the same day.
About two weeks later, the wound healed, but I began to experience discomfort, numbness, and a foreign body sensation, and even my gums felt uncomfortable.
When I returned for a follow-up, I informed the doctor, who said the wound looked like it had healed well.
If I continued to feel discomfort, he suggested injecting a small amount of corticosteroid to soften the scar.
Since I was very uncomfortable, I accepted the corticosteroid injection, and I felt that the scar softened a bit.
However, I still experience a tingling sensation and a foreign body feeling at the surgical site every day, and my gums remain uncomfortable.
Could you please advise me on how to manage this and what further medical attention I might need to return to normal?
The biopsy report from the first surgery on 12/22/112 states: Oral cavity, gingiva, lower left, excision, (1) mucocele (2) chronic sialadenitis.
The biopsy report from the second surgery on 1/19/113 states: Oral cavity, gingiva, lower left, excision, chronic inflammation.

Mei, 30~39 year old female. Ask Date: 2024/03/26

Dr. Zheng Jueyi reply Otolaryngology

It is common to experience temporary sensory abnormalities after surgery, which usually resolve gradually.
You may consider taking B vitamins.
If discomfort persists, it is recommended to follow up with the original surgeon for further treatment.

Reply Date: 2024/03/26

More Info

After undergoing surgery for the removal of a salivary gland cyst, it is not uncommon to experience discomfort, numbness, or a sensation of foreign body presence in the surgical area. These symptoms can be particularly pronounced when the surgery involves delicate structures such as the oral cavity and gingiva, as in your case.

Understanding Post-Surgical Symptoms
1. Numbness and Discomfort: The numbness and discomfort you are experiencing may be due to nerve irritation or damage during the surgical procedure. The oral cavity is densely innervated, and any surgical manipulation can lead to temporary or, in some cases, prolonged changes in sensation.
2. Scar Tissue Formation: After surgery, scar tissue can form, which may contribute to a sensation of tightness or discomfort. The injection of steroids, as suggested by your physician, is a common approach to help soften the scar tissue and reduce inflammation. This can alleviate some of the discomfort associated with scar formation.

3. Chronic Inflammation: The pathology reports from both surgeries indicate chronic inflammation, which suggests that the tissue may still be healing or reacting to the surgical intervention. Chronic inflammation can lead to ongoing discomfort and may require further management.

Recommendations for Management
1. Follow-Up with Your Surgeon: It is essential to maintain open communication with your surgeon regarding your symptoms. If the discomfort persists, further evaluation may be necessary to rule out any complications such as infection or improper healing.

2. Physical Therapy: In some cases, physical therapy focused on the oral and facial regions can help alleviate discomfort. A therapist can provide exercises to improve mobility and reduce the sensation of tightness.

3. Medication: If the discomfort is significant, your physician may recommend pain management strategies, including over-the-counter pain relievers or prescription medications. Additionally, topical treatments may be beneficial for localized discomfort.

4. Steroid Injections: If you have not already done so, discussing the possibility of additional steroid injections with your physician could be beneficial. These injections can help reduce inflammation and improve symptoms.

5. Avoiding Irritants: Be mindful of your diet and oral hygiene. Avoiding spicy, acidic, or hard foods that may irritate the surgical site can help minimize discomfort. Maintaining good oral hygiene is crucial to prevent infections that could exacerbate inflammation.

6. Monitoring Symptoms: Keep a record of your symptoms, noting any changes in intensity or character. This information can be valuable for your healthcare provider in determining the best course of action.

Prognosis and Recovery
Most patients experience gradual improvement in symptoms over time. However, the duration of recovery can vary significantly based on individual healing processes and the extent of the surgery. While some patients may notice significant improvement within weeks, others may take several months to feel completely normal.
If symptoms do not improve or worsen, further diagnostic imaging or interventions may be necessary. In rare cases, surgical revision may be considered if there are significant concerns about scar tissue or nerve involvement.

Conclusion
In summary, while post-surgical discomfort after salivary gland cyst removal can be distressing, it is often manageable with appropriate care and follow-up. Engaging with your healthcare team, adhering to recommended treatments, and being proactive about your recovery will contribute to a better outcome. If you have ongoing concerns, do not hesitate to seek further evaluation to ensure that your healing process is on track.

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