AboutJoel S. Teig, DMD, FABOMS Expertise I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.
Experience Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.
Organizations American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons
Question QUESTION: An ENT doctor surgically removed a mucocele I had in my lower inside lip. The mucocele reappeared at the same place about a month after the surgery. I went back to the doctor who told me that since the healing is not completed yet and since the lab test showed that the mucocele was not a tumor, we should wait to see how it evolves. I think the mucocele is coming from another saliva gland. My question is as follow, should I wait and see as per my doctor's recommendation or is it better to remove this new mucocele now? I thought that since the inflammation is still there performing a new surgery might be less painful than if I wait until the healing is over to which point I would have to start all over again. The doctor said that we cannot foresee how this mucocele will evolve and it's better to wait until the healing of the last surgery is done.
ANSWER: John - It is obvious that the ENT doctor really knows very little about mucoceles and how to treat them. Yes, surgical removal is correct, but since there are hundreds of minor salivary glands in close proximity to each other, the removal of the mucocele requires that all the adjoining minor salivary glands next to the mucocele also be removed. If not, the ducts that allow the saliva from the glands to get into the mouth, will become blocked and form another mucocele. You will most likely need a redo, but just one month is a little early.
You should wait about 2 months since the surgery to see a board certified oral and maxillofacial surgeon to evaluate the area. The board certified oral and maxillofacial surgeons remove many, since they work in the area moreso than other doctors.
So get an evaluation, if the mucocele is still present in a few weeks, you will need to have surgery to remove the mucocele.
---------- FOLLOW-UP ----------
QUESTION: Thanks for the quick reply! The doctor told me he removed salivary glands located in the surrounding area during the surgery so I am just wondering if it's common for mucocele to come back during the healing process. If that's the case the next surgery might lead to the same symptom unless the surgeon removes more glands than needed.
Answer John - Not seeing the surgery, it is a little difficult for me to tell you if the doctor fully removed enough glands. He may have left just one and that could have caused the present problem. If the area does not get better, them a redo of the surgery will be necessary.
There is something that I suggest that might help reduce the swelling. Start warm salt water rinses that goes against the lip. In addition, use a warm moist wash cloth and put it on the lip for about 10 minutes 3-4 times a day. Occasionally just these warm moist treatments can reduce the swelling.
I wish you well and hope you won't need another surgery.
