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SALIVARY MUCOCOELE

A salivary mucocoele is an accumulation of saliva in the tissues of the neck and under the chin.  Saliva leaks from the joined salivary glands (mandibular and sub-lingual glands) which are located at the back of the jaw and extend forwards under the jaw and open underneath the tongue.  The saliva leaks from the glands either due to trauma of the gland or openings (salivary ducts), infection, tumour, or stones (sialoliths).  A mucocoele can often be very large, but is often not painful or cause significant problems, but occasionally can cause obstruction of the airway and difficulty breathing.  The swelling may increase and decrease in size as a direct response to the presence of food and production of saliva.  Excision of the productive salivary tissue will prevent further swelling in the future and is generally completely curative.   

 

The main complications associated with surgery are infection or seroma formation (accumulation of serous fluid in the space of the previous mucocoele).  Rarely a small amount of salivary tissue may be left behind during dissection and cause further accumulation of saliva, but this may be managed by further surgical excision.

 

Healing will take 4-6 weeks for the soft tissues to form scar tissue and completely resolve the fluid swelling.  Following excision of the glands, there may be accumulation of serous fluid in the space where the saliva once was.  This serous fluid is normal watery-type fluid produced by the body in reaction to the trauma of surgery and the empty space let behind by the mucocoele, similar to the fluid produced when you get a nasty graze on your skin.  This seroma (collection of serous fluid) may be quite large, and similar in size to the previous saliva accumulation.  This is not of concern unless it causes difficulty breathing or increased noise whilst breathing, or becomes firm and hot indicating infection.  The serous fluid accumulation will resolve over the coming 2-4 weeks as the body gradually resorbs the fluid.  The use of heat packs to the area 4 times daily for 20 minutes will aid circulation and resolution of the swelling.