Swelling under the jaw can feel disconcerting, especially if it appears unexpectedly or begins to affect eating and speech. While there are several possible causes, one commonly overlooked culprit is a problem with the parotid gland, one of the body’s major salivary glands.
Parotid Gland Swelling: Parotitis, Tumours and Parotid Cancer
Dr Thomas Ho
Senior Consultant General and Head & Neck Surgeon, Accredited Surgical Oncologist
MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery)
What is the Parotid Gland and What Does It Do?
The parotid glands are the largest salivary glands in the face. Their primary role is to produce saliva, which assists in breaking down food during digestion, keeping the mouth moist and helping you enunciate clearly.
Every time you eat, smell food, or even think about eating, your parotid glands are stimulated to produce saliva. This flows into your mouth through a small tube called the parotid duct.
The glands sit in front of and below the ears, extending toward the jawline, which is why any swelling or enlargement tends to be visible along the jaw.
The Specialist Leading Your Care
Dr Thomas Ho
Medical Director, Senior Consultant Head & Neck Surgeon
20+ Years of Clinical Experience
MBBS(Sydney), MMed(Surg), AFRCS(Ireland), FRCS(Edinburgh), FAMS(General Surgery), FSSO(USA)
Dr. Thomas Ho is a distinguished surgeon well known for his expertise in Cancer Surgery, especially in the field of Head and Neck cancers as well as Abdominal and Digestive cancers. In 2009 he was awarded a MOH scholarship and completed a Surgical Oncology Fellowship in Canada, becoming one of only a handful of surgeons in Singapore with this recognition.
Prior to private practice, Dr. Ho founded the Head and Neck Surgery and Surgical Oncology service at Tan Tock Seng Hospital. Dr. Ho is experienced in laparoscopic (keyhole) and robotic-assisted surgery, which he routinely employs in the treatment of thyroid cancer, colorectal cancer, hernias, gallbladder diseases, adrenal and spleen disorders.
Why Does Parotid Gland Swelling Occur?
Swelling occurs when the normal production or flow of saliva is disrupted, leading to inflammation, pressure build-up or enlargement of the gland. Common underlying causes include:
| Cause | What Happens |
|---|---|
| Salivary duct stones (sialoliths) | Calcified deposits block saliva flow, causing it to back up and the gland to swell, often most noticeable during mealtimes. |
| Parotitis (bacterial or viral infection) | Inflammation of the parotid gland — known as parotitis — leads to pain, swelling and sometimes fever or discharge. Viral parotitis includes mumps. |
| Tumours (benign or cancerous) | Growths can enlarge the gland, presenting as a persistent, painless lump. Requires prompt evaluation. |
| Reduced saliva flow | Dehydration, certain medications or systemic conditions can thicken saliva and increase the risk of blockage. |
| Autoimmune conditions | Disorders such as Sjögren's syndrome cause chronic inflammation and dryness of the salivary glands. |
Symptoms of Parotid Gland Conditions
Parotid gland problems, including parotitis, rarely present with swelling alone. If you experience any of the following alongside jaw swelling, arrange a specialist consultation promptly:
- Mealtime swelling Swelling that appears or worsens when eating is a classic sign of salivary duct obstruction or a stone.
- Foul taste in the mouth A salty or bitter taste, particularly around mealtimes, may indicate infection or discharge from the gland.
- Jaw stiffness or difficulty swallowing Inflammation or enlargement of the gland can restrict jaw movement and make swallowing uncomfortable.
- Facial weakness or asymmetry Any weakness, drooping or asymmetry, particularly around the eyes, requires urgent evaluation as it may indicate nerve involvement.
- Dry mouth Reduced saliva production can be a sign of gland dysfunction or an underlying autoimmune condition.
- Fever and rapid swelling (parotitis) Sudden swelling accompanied by fever is a hallmark of acute parotitis, either bacterial or viral, and should be assessed promptly.
- Fluid or discharge from the ear An uncommon but notable symptom that may indicate spread of infection or other gland pathology.
How Serious Is Parotid Gland Swelling?
The severity depends on the underlying cause. Many cases, particularly those linked to salivary stones, mild infections or viral illness, are manageable with conservative treatment or a minimally invasive procedure.
However, parotid swelling should never be assumed to be harmless. Persistent or recurrent swelling can point to a chronic blockage or structural issue. Firm, painless lumps may indicate a tumour that requires prompt evaluation.
Arrange a specialist consultation if you notice any of the following:
- Swelling present and growing for more than a few weeks
- The lump is painless
- The lump feels firm or fixed to underlying tissue
- Associated facial weakness, numbness or asymmetry
- Unexplained weight loss or fatigue
- A lump in the neck as well
Treatment for Parotid Gland Disorders
Treatment depends on the underlying cause. Bacterial parotitis is typically managed with antibiotics and increased hydration. Viral parotitis runs its course with rest and supportive care. However, many parotid and salivary gland conditions ultimately require surgical intervention.
| Procedure | When It Is Indicated |
|---|---|
| Salivary stone removal | Calcified stone blocking the parotid duct, causing recurrent mealtime swelling and pain. |
| Partial parotidectomy | Removal of part of the parotid gland, used for localised tumours or chronic structural disease. |
| Total parotidectomy | Complete removal of the gland. Necessary when cancer is confirmed or disease involves the full gland. |
For a full overview of salivary gland conditions we treat, from stones and infections to tumours, visit our salivary gland surgery page.
Recovery After Parotid Gland Surgery
Salivary gland surgery is technically demanding and should be performed by an experienced head and neck surgeon.
The facial nerve, which controls all facial movements, runs directly through the parotid gland. Inadvertent injury during surgery can lead to facial weakness or drooping, which may be temporary but in some cases is permanent. Patients may also experience difficulty with facial expressions if the nerve is compromised.
Choosing a surgeon with deep anatomical knowledge and meticulous technique is essential to minimising this risk and preserving normal facial function.
Recovery After Parotid Gland Surgery
Recovery from parotid gland surgery is generally straightforward, though it varies depending on the extent of the procedure. Most patients are discharged within one to two days and are able to return to light daily activities within one to two weeks.
Swelling and mild discomfort around the jaw and ear are common in the first few days and typically settle with prescribed pain relief. A soft diet is recommended in the initial recovery period to reduce strain on the surgical area.
Your surgeon will schedule follow-up appointments to monitor healing, review pathology results if a tumour was removed, and assess facial nerve function. In cases where the facial nerve was affected during surgery, physiotherapy or targeted exercises may be recommended to support recovery.
Full recovery and return to normal activities typically occurs within four to six weeks, though this may be longer for more extensive procedures such as total parotidectomy.
Contact your surgeon promptly if you experience any of the following after discharge:
- Increasing swelling, redness or warmth around the wound
- Discharge or bleeding from the incision site
- Facial weakness or drooping that was not present immediately after surgery
- Difficulty swallowing or opening the mouth
- Fever above 38°C
Concerned about a parotid gland disorder?
Book a consultation with Dr Thomas Ho to discuss your condition and treatment options.
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Frequently asked questions
Is parotid gland swelling contagious?
The swelling itself is not contagious. However, viral parotitis caused by mumps is contagious and can spread through saliva or respiratory droplets. Bacterial parotitis and swelling caused by stones or tumours are not contagious.
Can parotid gland swelling go away on its own?
Mild cases caused by dehydration or viral infection may resolve with rest and hydration. However, swelling caused by salivary stones, bacterial infection or a tumour will not resolve without treatment. Any swelling lasting more than two weeks should be assessed by a specialist.
What is the difference between the parotid gland and the submandibular gland?
Both are major salivary glands but are located in different areas. The parotid gland sits in front of and below the ear, while the submandibular gland is located directly under the jaw. A lump near the ear is more likely parotid in origin; a lump directly under the chin or jaw may involve the submandibular gland.
Will I lose facial movement after parotid surgery?
Temporary facial weakness is possible after parotid surgery due to the proximity of the facial nerve. Permanent damage is uncommon when surgery is performed by an experienced head and neck surgeon. Your surgeon will discuss this risk with you prior to any procedure.
Is parotid surgery covered by insurance in Singapore?
Parotid surgery performed in a private hospital in Singapore may be covered by an Integrated Shield Plan and Medisave, depending on the diagnosis and insurer. Thomas Ho Surgery assists patients with insurance coordination and pre-authorisation where applicable.
How is a parotid tumour diagnosed?
Diagnosis typically involves a clinical examination, followed by imaging such as an ultrasound or MRI to assess the size and nature of the lump. A fine needle aspiration cytology (FNAC) may also be performed to sample cells from the lump and determine whether it is benign or malignant.
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References
- MSD Manuals. Salivary Gland Disorders.
- Goker F, et al. (2022). Solitary fibrous tumor of parotid gland: a case report and short review of literature. European Review for Medical and Pharmacological Sciences, 26(3 Suppl), 45–50. doi:10.26355/eurrev_202212_30794
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