Salivary Gland Ablation Treatment and Recovery :: Nationwide Children's Hospital

Salivary Gland Ablation Treatment and Recovery

Our interventional radiologists are unique because we have the greatest, worldwide experience in salivary gland ablation for ranulas, too much saliva, and drooling. Patients travel to Nationwide Children's Hospital from all over the country for safe and effective salivary gland ablation.

If you, or your child, have been told you need a salivary gland ablation and want to pursue minimally invasive treatment, call our Interventional Coordinator at (614) 722-2375 to set up a consultation with an Interventional Radiologist. You may also request an appointment using our online form.

Salivary Gland Ablation Treatment

Salivary gland ablation is a procedure performed by an interventional radiologist during which drugs are injected into the major salivary glands (submandibular, sublingual, and parotid glands), causing the salivary gland tissue to shrivel up and turn to scar tissue.

Treatment Alternatives

There are three alternatives to salivary gland ablation:

  • Do nothing except monitor the excess saliva or ranula to see if this problem is severe enough for patients' or families to seek treatment
  • Medical therapy for too much saliva will reduce saliva production (medication will be given for a long time). Note: there is no medical therapy for ranula.
  • Surgical removal of the salivary glands

How is a salivary gland ablation performed?

Salivary gland ablation is performed with precise injection of two drugs, first a medical detergent, followed by pure alcohol (ethanol). Some injections are delivered through the normal salivary gland drainage tubes (ducts), while other injections are delivered through the skin, directly into the salivary gland tissue. To provide precise delivery of the ablation drugs, injection needles and tubes (catheters) are guided with ultrasound and/or x-ray cameras. Depending on the diagnosis of too much saliva or ranula, salivary gland ablation is performed on either one gland, for treatment of a ranula; or either one, two, three or more glands for the saliva excess. Salivary gland ablation for too much saliva can be tailored, depending on the severity and after discussion with the patient/patient’s family, so that reduction of saliva production by at least 50% is achieved by ablation of some of the glands on the right, or glands on both right and left sides.

Will my child be awake during the procedure?

Most patients undergo salivary gland ablation while asleep with general anesthesia. A ranula is potentially treatable in adults while the patient is awake, using precise injection of local anesthetic into the tissue surrounding the salivary gland, before salivary gland ablation. Adults are occasionally treated if they have a childhood disorder that progresses into adulthood.

How long will the procedure take?

Salivary gland ablation is usually performed within 1 hour.

Salivary Gland Ablation Risks

The risks of salivary gland ablation are similar to those with surgery, including a very low risk of infection, nerve injury (branches of the facial nerve), or skin injury.

What happens after the procedure?

Since salivary gland ablation is performed through small needle injections and without surgical incisions, there are no bandages to change or stitches to remove. Since salivary gland ablation is effectively killing salivary gland tissue, the body reacts to this tissue injury with swelling and bruising in the area of the treated salivary glands. Swelling after salivary gland ablation can be quite severe (patients who can communicate tell us that the swelling is painless) and lasts approximately 7-10 days. Most patients treated for too much saliva report reduction in salivary gland production within 4-7 days after treatment. Since the ablated tissue turns to scar tissue, the treated gland tissue is unable to produce normal amounts of saliva. Patients treated for ranula should expect the tongue to be numb (only on the side of treatment, right or left) for 3-4 weeks.

When can my child bathe?

A child treated with salivary gland ablation may bathe immediately following the ablation procedure.

Are there any activity restrictions?

There are no activity restrictions following salivary gland ablation.

Will my child need another salivary gland ablation?

Patients treated for a ranula will be cured following a single salivary gland ablation procedure in 85% of the cases. Patients treated for too much saliva or drooling may need a second treatment, based on the severity of the saliva, if they breathed in saliva, or drooling. Patients often start with one side (most often right side) salivary gland ablation, observe the response to treatment for a few weeks, and then decide if more glands require treatment.

What can my child expect after treatment is complete? Any long-term effects?

Treatment is successful in 96% of the patients treated for too much saliva, with the average amount of saliva production being 67%. After more than 10 years of salivary gland ablation, patients are able to resume life normally, without complications following salivary gland ablation (to include no patients complaining of dry mouth or excessive tooth decay). Salivary gland ablation for ranula is effective 95% of the time, with 5% of patients requiring surgical removal of the affected salivary gland.

What happens if this is left untreated?

Patients not treated for excess saliva will continue to drool, choke on their saliva, or breath in their saliva. Often this will lead to recurrent pneumonia and possibly death from aspiration pneumonia. Patients with an untreated ranula will continue to experience the pain and swelling of the ranula, and if infected, can result in serious neck abscesses requiring hospitalization and abscess drainage procedures.

Salivary Gland Ablation Treatment and Recovery

Our interventional radiologists are unique because we have the greatest, worldwide experience in salivary gland ablation for ranulas, too much saliva, and drooling. Patients travel to Nationwide Children's Hospital from all over the country for safe and effective salivary gland ablation.

If you, or your child, have been told you need a salivary gland ablation and want to pursue minimally invasive treatment, call our Interventional Coordinator at (614) 722-2375 to set up a consultation with an Interventional Radiologist. You may also request an appointment using our online form.

Salivary Gland Ablation Treatment

Salivary gland ablation is a procedure performed by an interventional radiologist during which drugs are injected into the major salivary glands (submandibular, sublingual, and parotid glands), causing the salivary gland tissue to shrivel up and turn to scar tissue.

Treatment Alternatives

There are three alternatives to salivary gland ablation:

  • Do nothing except monitor the excess saliva or ranula to see if this problem is severe enough for patients' or families to seek treatment
  • Medical therapy for too much saliva will reduce saliva production (medication will be given for a long time). Note: there is no medical therapy for ranula.
  • Surgical removal of the salivary glands

How is a salivary gland ablation performed?

Salivary gland ablation is performed with precise injection of two drugs, first a medical detergent, followed by pure alcohol (ethanol). Some injections are delivered through the normal salivary gland drainage tubes (ducts), while other injections are delivered through the skin, directly into the salivary gland tissue. To provide precise delivery of the ablation drugs, injection needles and tubes (catheters) are guided with ultrasound and/or x-ray cameras. Depending on the diagnosis of too much saliva or ranula, salivary gland ablation is performed on either one gland, for treatment of a ranula; or either one, two, three or more glands for the saliva excess. Salivary gland ablation for too much saliva can be tailored, depending on the severity and after discussion with the patient/patient’s family, so that reduction of saliva production by at least 50% is achieved by ablation of some of the glands on the right, or glands on both right and left sides.

Will my child be awake during the procedure?

Most patients undergo salivary gland ablation while asleep with general anesthesia. A ranula is potentially treatable in adults while the patient is awake, using precise injection of local anesthetic into the tissue surrounding the salivary gland, before salivary gland ablation. Adults are occasionally treated if they have a childhood disorder that progresses into adulthood.

How long will the procedure take?

Salivary gland ablation is usually performed within 1 hour.

Salivary Gland Ablation Risks

The risks of salivary gland ablation are similar to those with surgery, including a very low risk of infection, nerve injury (branches of the facial nerve), or skin injury.

What happens after the procedure?

Since salivary gland ablation is performed through small needle injections and without surgical incisions, there are no bandages to change or stitches to remove. Since salivary gland ablation is effectively killing salivary gland tissue, the body reacts to this tissue injury with swelling and bruising in the area of the treated salivary glands. Swelling after salivary gland ablation can be quite severe (patients who can communicate tell us that the swelling is painless) and lasts approximately 7-10 days. Most patients treated for too much saliva report reduction in salivary gland production within 4-7 days after treatment. Since the ablated tissue turns to scar tissue, the treated gland tissue is unable to produce normal amounts of saliva. Patients treated for ranula should expect the tongue to be numb (only on the side of treatment, right or left) for 3-4 weeks.

When can my child bathe?

A child treated with salivary gland ablation may bathe immediately following the ablation procedure.

Are there any activity restrictions?

There are no activity restrictions following salivary gland ablation.

Will my child need another salivary gland ablation?

Patients treated for a ranula will be cured following a single salivary gland ablation procedure in 85% of the cases. Patients treated for too much saliva or drooling may need a second treatment, based on the severity of the saliva, if they breathed in saliva, or drooling. Patients often start with one side (most often right side) salivary gland ablation, observe the response to treatment for a few weeks, and then decide if more glands require treatment.

What can my child expect after treatment is complete? Any long-term effects?

Treatment is successful in 96% of the patients treated for too much saliva, with the average amount of saliva production being 67%. After more than 10 years of salivary gland ablation, patients are able to resume life normally, without complications following salivary gland ablation (to include no patients complaining of dry mouth or excessive tooth decay). Salivary gland ablation for ranula is effective 95% of the time, with 5% of patients requiring surgical removal of the affected salivary gland.

What happens if this is left untreated?

Patients not treated for excess saliva will continue to drool, choke on their saliva, or breath in their saliva. Often this will lead to recurrent pneumonia and possibly death from aspiration pneumonia. Patients with an untreated ranula will continue to experience the pain and swelling of the ranula, and if infected, can result in serious neck abscesses requiring hospitalization and abscess drainage procedures.

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