Possible problems after salivary gland cancer surgery

There is a risk of problems or complications after any operation.

Possible problems after surgery for salivary gland cancer include changes in eating, talking, and appearance. Other risks include infection, blood clots and bleeding.

Your surgeon will tell you which problems you are likely to have after the operation. Let your doctor or nurse know if you feel unwell or are worried about anything.

Possible problems or complications are different if you have surgery to remove the lymph nodes in your neck.

Bleeding from the wound

You might have a small amount of blood on your wound dressing after surgery, which is normal. Your nurse will regularly check your dressing after the operation. Tell your doctor or nurse straight away if you have a lot of bleeding after surgery.

Infection

You might have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of an infection. They include:

a high temperature (fever)
feeling generally unwell
shivering
feeling hot and cold
feeling sick
swelling or redness around your wound

Nerve damage

The nerves controlling movement and feeling in your face and mouth can be affected by the tumour or by surgery to the salivary glands. This is usually temporary but occasionally may be permanent. The symptoms you might have depend on the salivary gland that is affected.

Numbness and weakness

Surgery for a parotid gland cancer can cause numbness in the earlobe and the skin around the wound. Or you may have facial weakness so that your face looks droopy.

This is usually temporary and only affects the side of the face where you had surgery.

Sweating of the face at meal times

Some people have sweating of the face at meal times. This is called Frey's syndrome. It happens when nerves that control the production of saliva grow and join nerves that control the sweating of the skin.

This may happen many months or even years after your operation.

Problems moving the lower lip

Surgery for submandibular gland cancer can affect the nerve that controls movement in your lower lip. This can mean that you have a crooked smile. The nerve that controls feeling in the side of the tongue can also be bruised during surgery, causing numbness.

These effects are usually temporary, but in rare cases can be permanent.

Numbness and loss of sensation in the tongue

Surgery to the sublingual salivary gland can make your tongue numb. This is caused by bruising and swelling in the area.

You can also lose the sensation on the back of the tongue. This is rare and can be caused by damage to a nerve called the lingual nerve.

Problems closing your eye

You can have problems closing your eye after surgery for parotid gland cancer. This is usually temporary.

Your doctor or nurse might give you eye drops or lubricants to stop the eye from drying too much. You can also wear an eye patch or tape the eye at night.

A salivary fistula

A salivary fistula (or sialoceles) is a passage between the skin and the salivary gland. This can happen after surgery for parotid gland cancer.

This is usually temporary, but in rare cases can be permanent. Your surgeon might need to put a drain in and a dressing over the fistula. They can also give you some drugs to help to reduce the amount of saliva you produce.

Tiredness and pain

The nerves controlling movement and feeling in your face and mouth can become weak from surgery. This is usually temporary but occasionally may be permanent.

Feeling tired and weak

Most people feel weak and lack strength for some time afterwards. How long this lasts varies between people.

Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.

Pain

Some people find they have pain that lasts for some time after surgery. This might be from damage to nerves during the operation. The pain often runs along the operation scar. For most people, it gradually reduces after some weeks as the nerves repair themselves. But for some people, it might continue for longer.

This pain can be difficult to get under control, so it is important to let your specialist nurse or surgeon know if you are in pain. They can refer you to a pain clinic for specialist help.

Changes to chewing and swallowing

You may see a speech and language therapist (SLT) before you start treatment if surgery is likely to affect your swallowing. An SLT can assess your swallowing during and after treatment. They can teach you exercises to support you with swallowing difficulties. And they work with a dietitian if you are finding it difficult to eat.

Coping

Surgery for salivary gland cancer can change how you look and how you eat and drink. This can affect your self esteem. Most changes are temporary, but some can be permanent.

It can be very difficult to cope with some of the changes, but there are some things you can do. Knowing what to expect can help you cope with problems after surgery.