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NYU Langone doctors often perform surgery to manage cancer that develops in the salivary glands, which produce saliva to help break down food for swallowing and digestion.
The type of surgery doctors perform to remove a salivary gland tumor depends on where the tumor is located. Cancer most often develops in the parotid glands, which are located on the sides of the face in front of the ears.
Cancer can also develop in the submandibular salivary glands, which are located in the upper neck below the jaw. Rarely, it can develop in the sublingual glands, found under the floor of the mouth, beneath the tongue, and in microscopic glands located throughout the mouth and throat.
Radiation therapy—the use of high energy beams to destroy cancer cells—is sometimes used after surgery to destroy any remaining cancer. Doctors may give chemotherapy at the same time to make cancer cells more sensitive to radiation therapy. This approach is called chemoradiation.
Most of the time, doctors manage salivary gland cancer with open surgery, which requires an incision in the face or neck, near where the tumor is located. General anesthesia is used during this procedure.
Parotid Gland Surgery
To remove parotid gland cancer, the surgeon makes an incision in front of your ear and into the upper neck. He or she removes the tumor, the gland, and some surrounding healthy tissue. This margin of healthy tissue helps ensure all cancer cells have been removed.
When removing parotid gland tumors, NYU Langone doctors try to preserve the facial nerve, which runs through the gland and helps control facial expressions, such as smiling, moving your eyebrows, and blinking. Sometimes doctors use nerve monitoring during surgery. This enables them to identify any changes in the function of the facial nerve, helping prevent damage.
If the tumor is extensive and the facial nerve must be removed or cut during surgery, NYU Langone surgeons can use a nerve graft to restore function. The graft is typically a piece of nerve taken from nearby neck tissue or another area of the body. It may come from the leg, for instance, where its absence isn’t noticeable and doesn’t interfere with any functions.
Submandibular Gland Surgery
To remove submandibular gland cancer, the surgeon makes an incision in the upper neck below the jaw to remove the tumor and the gland in which it is growing. The surgeon also takes out a margin of surrounding tissue to help ensure all of the cancer has been removed.
The doctor tries to preserve nearby nerves that help move the tongue, provide information about tongue sensation and taste to the brain, and control muscle movement in the lower portion of the face. If nerves need to be removed, they can be reconstructed with grafts.
Neck dissection is a procedure to remove lymph nodes. If salivary gland cancer has spread to nearby lymph nodes, or if the nodes look swollen or otherwise suspicious, doctors may perform a neck dissection, in which they remove lymph nodes by making an incision in the neck.
Lymph nodes are small, bean-shaped organs that make and store lymphocytes, which are white blood cells that help fight infection. Lymphocytes travel throughout the body via a network of vessels. Salivary gland cancer can spread to the lymph nodes through these vessels.
Depending on the location of the salivary gland cancer, our doctors may use transoral surgery—meaning that it’s performed through the mouth—to remove tumors and surrounding tissue.
Surgeons may use transoral surgery to remove sublingual gland cancer, which is found under the floor of the mouth, beneath the tongue. They may also perform this type of surgery to remove minor salivary gland cancer, which can arise in the tongue and the soft palate—the spongy tissue in the back of the mouth. Transoral surgery may also be used to remove salivary gland tumors that have grown into the upper jaw.
These procedures are performed using general anesthesia.
Transoral surgery may be combined with a neck dissection if lymph nodes in the neck that contain cancer need to be removed.
Recovery from Surgery
Most surgery for salivary gland cancer is performed on an outpatient basis, meaning you can go home the same day. Staying overnight may be necessary for more extensive procedures that require lymph node removal.
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