Parotid gland swelling and lumps

What is the parotid gland?

The parotid glands lie in front of and below each ear. They produce saliva, which drains into the cheek. Swelling may reflect a blocked duct, infection, inflammation or a tumour. Many parotid tumours are benign (non-cancerous).

Features that may be more reassuring

Swelling that comes and goes with meals is more suggestive of a blocked saliva duct. A lump that grows slowly and moves under the skin can be benign. These patterns do not rule out cancer: a persistent, unexplained lump needs assessment even if it is painless.

Red flags: arrange prompt assessment

Contact your GP or specialist promptly for a persistent or enlarging lump, rapid growth, a lump that feels fixed, increasing unexplained pain, numbness or another lump in the neck. These features do not necessarily mean cancer, but need investigation.

When to seek urgent help

Seek same-day GP or NHS 111 advice for painful swelling with fever, redness or pus, or if you cannot drink enough. New facial weakness also needs urgent assessment. Call 999 for sudden facial droop, especially with arm weakness or speech difficulty.

Call 999 for breathing difficulty, rapidly increasing swelling under the tongue or in the neck, or inability to swallow your saliva. Do not wait for a routine appointment.

How is it assessed?

Assessment includes your symptoms, examination of the mouth and neck, and often ultrasound. A persistent lump may need an ultrasound-guided needle sample; MRI or CT is sometimes helpful. Tests are considered together rather than relying on how a lump feels.

Treatment and self-care

Treatment depends on the cause. A blockage may be treated through the duct, sometimes using a miniature camera (sialendoscopy). Bacterial infection may need antibiotics. A tumour needs an individual plan, which may include surgery. The facial nerve runs through the gland, so any operation requires discussion of the risk of facial weakness.

For suspected blockage, keep hydrated and try gentle massage and sugar-free gum if comfortable. Do not probe the duct with sharp objects. Persistent or recurring symptoms need review.