Salivary Gland Issues: My Surgery Journey and Next Steps

I have developed a tophus, but it hasn't improved after surgery?

Hello Dr.
Lin,
On December 25, 2006, I noticed swelling under my jaw.
At that time, I had a cold and thought it was related to it, so I went to an ENT specialist for my cold.
The doctor diagnosed me with a ranula and referred me to a private hospital.
After surgery on December 28, my condition did not improve, but the surgeon said it was normal.
Initially, when I ate, water would spray out from the surgical site (like a water fountain).
During my follow-up on January 2, the doctor surprisingly advised me not to eat too many delicious foods, as it would lead to excessive saliva production, and claimed that my symptoms were normal, thus concluding all consultations.
I remember the suturing process during the surgery because I heard the doctor tell someone nearby that he forgot to leave an opening, so he instructed to cut the sutures.
From January 2 to February 25, my sublingual area continued to swell.
On February 25, I visited a dentist who informed me that the surgery had failed and that the surgical method was incorrect, so he needed to perform another surgery (at the hospital where he also works).
The dentist explained that they would create a pouch and initially use packing to prevent the area from closing up.
However, there is a possibility of recurrence (within a week post-surgery) because the surgical process can damage tissue, raising concerns about recurrence, especially since this is not the first surgery.
Today, I found an article online where a doctor from a hospital stated that the pouch method is no longer suitable.
[http://www.libertytimes.com.tw/2006/new/jan/19/today-medicine1.htm] – this is the report! Can you please advise me on what to do? If the surgery fails again, what should I do? Is removing the salivary gland the solution?
Best regards,
Xiao Ru

Xiao Ru, 20~29 year old female. Ask Date: 2007/02/07

Dr. Lin Qingye reply Dentistry

Miss Xiao, this is a specialized issue, and it is recommended to visit a medical center with an oral surgery department for a detailed examination.
Wishing you a speedy recovery.
Dr.
Lin, February 15, 2007.

Reply Date: 2007/02/07

More Info

Dear 小如,
Thank you for sharing your experience regarding your salivary gland issues and the surgeries you've undergone. It sounds like you've been through a challenging journey, and I appreciate your willingness to seek further understanding and guidance.

From your description, it appears that you initially experienced swelling under your jaw, which was diagnosed as a condition known as "ranula" or "frog's belly." This condition often arises from the blockage of the sublingual gland or its ducts, leading to the accumulation of saliva. The surgery you underwent was likely intended to address this blockage, but it seems that the outcome did not meet your expectations, as you continued to experience swelling and other symptoms.

The fact that you were advised by the surgeon that your symptoms were normal is concerning, especially since you are still experiencing significant issues. The subsequent evaluation by your dentist, who suggested that the initial surgery was unsuccessful, indicates that there may have been complications or that the underlying issue was not adequately addressed.

Regarding your question about the use of a "bag" technique during surgery, it is essential to note that surgical techniques can vary widely based on the surgeon's experience and the specific condition being treated. While some methods may have been standard practice in the past, advancements in medical knowledge and techniques may render certain approaches less favorable today. It is crucial to consult with a specialist who is up-to-date with current practices and can provide you with the best options for your situation.

If you are considering another surgery, it is essential to have a thorough discussion with your surgeon about the potential risks, benefits, and the likelihood of success. You should also inquire about the possibility of recurrence and what measures can be taken to minimize that risk. A second opinion from another qualified otolaryngologist or oral surgeon may also be beneficial, as they can provide insights into alternative treatment options or confirm the necessity of further surgery.

In some cases, if conservative measures fail and the symptoms persist, surgical removal of the affected salivary gland may be considered. However, this decision should be made carefully, weighing the potential benefits against the risks, including the possibility of dry mouth or other complications that can arise from gland removal.

In the meantime, it may be helpful to manage your symptoms through hydration and avoiding foods that may exacerbate swelling or discomfort. Additionally, if you experience any signs of infection, such as fever or increased pain, you should seek medical attention promptly.

Ultimately, the best course of action is to have an open and honest conversation with your healthcare provider about your concerns and the next steps. They can help guide you through the decision-making process and ensure that you receive the appropriate care for your condition.

Wishing you the best in your journey toward recovery and health.

Sincerely,
Doctor Q&A Teams

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