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Sialoadenectomy is the surgical procedure to remove a salivary gland. This is an uncommon procedure, especially in cats.
Cats have four major pairs of salivary glands (on the right and left-hand sides) which produce saliva to keep the mouth moist and aid the chewing and swallowing of food. If the draining duct to a gland becomes blocked, then the saliva cannot drain out of the gland and a swelling known as a sialocoele develops.
A sialocoele can become large enough to displace the structures around it. Thus, for the zygomatic salivary gland this can cause the bulging of an eye, or a sublingual salivary gland the deviation of the tongue. However, the gland most commonly affected is the mandibular, causing a swelling in the throat.
Salivary glands are paired, one gland on the left and one on the right. The gland most commonly affected is the mandibular salivary gland which sits in the angle of the jaw. However, the swelling often appears to be centrally placed.
It is crucial the surgeon correctly identifies which side is affected. If the problem is relatively fresh then lying the cat on its back is often sufficient, as this allows the heavier sialocele to flop to the correct side. However, in long standing sialocele, considerable tissue damage has already occurred and advanced imaging techniques are necessary to correctly identify the affected gland.
Sialoadenectomy requires a full general anesthetic. The cat is then positioned with the affected gland uppermost, the fur clipped from the area, and the skin scrubbed.
Under aseptic conditions, the surgeon makes an incision over the gland and carefully dissects around it. There are many vital nerves and blood vessels in the throat area so great care is needed in order to avoid hemorrhage or nerve damage.
Once the gland is removed, the skin is sutured and the cat woken from the anesthetic.
Removal of the affected salivary gland is highly efficacious at resolving the problem. The earlier surgery is performed, the more straightforward the surgery is. This is because long standing sialoceles are associated with a lot of tissue damage, which can make identifying the gland difficult and increase the difficulty of successfully removing all the necessary tissue.
When all the gland is removed, recurrence is not possible.
Pain relief is advisable for a few days postoperatively, however, the majority of patients can go home the day after surgery. The cat is seen for a postoperative follow-up two to three days after surgery and at 10 to 14 days to remove sutures.
Recovery is usually uneventful with cats rapidly returning to normal.
Straightforward early sialoadenectomy may cost in the region of $800 to $1,000. More complex cases where damage to the surrounding tissue has occurred would cost more than this because of the extra surgical time required.
In addition, if more advanced imaging is needed in order to identify if the sialocele is left or right handed, this could add a further $800 to $1,500 to the bill.
Sialoceles do not respond to medical treatment, so surgical excision of the affected gland is the best action. Other strategies, such as marsupialization of the cyst tend not to be effective, with scar tissue rapidly blocking the side of the drain.
When performed soon after the development of the sialocele, surgery is likely to be entirely successful. Complications can occur with long standing sialocele where the anatomy of the region is damaged beyond recognition by the salivary enzymes.
Sialocele develop spontaneously as a result of a plug of material blocking the draining ducts. These plugs may be made up of sloughed cells, minerals, or even blood clots, thus they are hard to predict and therefore prevent.
Sialadenitis (inflammation or infection of the salivary gland) most commonly arises after a cat bite to the neck. Therefore, keeping your cat indoors or preventing fighting helps to prevent the need for sialoadenectomy.
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