Parotid Lumps: Causes, Assessment, and Treatment
A Hampshire ENT Clinics patient guide
A lump near the angle of the jaw or just in front of the ear is often related to the parotid gland, the largest of the salivary glands. While many parotid lumps are benign, any new or persistent swelling should be assessed by an ENT specialist.
At Hampshire ENT Clinics, we provide prompt, consultant-led assessment of parotid lumps, with access to modern imaging and specialist salivary gland surgery where required.
What Is the Parotid Gland?
The parotid glands sit on each side of the face, extending from the ear down towards the jaw. They produce saliva and contain important structures, including branches of the facial nerve, which controls facial movement.
Because of this anatomy, careful assessment is essential.
Common Causes of Parotid Lumps
1. Benign Parotid Tumours
The most common cause. Examples include:
Pleomorphic adenoma (most common benign tumour)
Warthin’s tumour (often linked to smoking)
These usually grow slowly and are painless.
2. Infection or Inflammation
Acute bacterial infection (parotitis)
Viral infections (e.g. mumps)
Chronic inflammatory salivary disease
Often associated with pain, redness, or swelling that worsens with eating.
3. Salivary Stones (Sialolithiasis)
Less common in the parotid than other salivary glands, but can cause intermittent swelling, especially around mealtimes.
4. Malignant (Cancerous) Tumours
Less common, but important to exclude. Red flags include rapid growth, pain, skin involvement, facial weakness, or firm fixation.
Symptoms That Should Prompt ENT Review
A lump in front of the ear or at the angle of the jaw
Progressive or persistent swelling
Pain, especially with meals
Facial weakness or asymmetry
Skin changes over the lump
How Are Parotid Lumps Investigated?
Assessment typically includes:
Clinical examination by an ENT specialist
Ultrasound scan of the parotid gland
Fine needle aspiration (FNA) to sample cells, if indicated
MRI or CT scanning for deeper or complex lesions
This structured approach helps distinguish benign from malignant conditions and guides treatment.
Treatment Options
Observation
Small, clearly benign lumps may be monitored with imaging and follow-up.
Medical Treatment
Infective or inflammatory causes are treated with antibiotics, hydration, massage, and supportive care.
Surgery (Parotidectomy)
Surgery is recommended for:
Most parotid tumours (even benign ones, due to growth and malignant risk)
Symptomatic or enlarging lumps
Suspicion of malignancy
Parotid surgery is highly specialised due to the facial nerve, and should be performed by experienced ENT surgeons.
Frequently Asked Questions (FAQs)
Are most parotid lumps cancerous?
No. The majority of parotid lumps are benign, but assessment is essential to be sure.
Is a painless lump more worrying?
Not necessarily. Many benign tumours are painless. Concerning features include rapid growth, pain, skin changes, or facial weakness.
What is a fine needle aspiration (FNA)?
FNA is a simple clinic procedure using a thin needle to sample cells from the lump. It helps guide diagnosis and treatment planning.
Will I need surgery for a benign lump?
Often yes. Benign parotid tumours can continue to grow and, in some cases, change over time. Surgery is usually advised, particularly for pleomorphic adenomas.
Is facial weakness common after parotid surgery?
Temporary weakness can occur, but permanent facial nerve injury is uncommon when surgery is performed by experienced specialists.
Can parotid lumps be caused by infection?
Yes. Infections can cause painful swelling, often with redness and systemic symptoms. These are usually treated medically rather than surgically.
How urgently should I be seen?
Any new or persistent parotid lump should be assessed promptly. Urgent review is recommended if there is facial weakness, rapid growth, or pain.
Where can I be assessed?
Assessment and investigation are available at Hampshire ENT Clinics, with consultant-led care across Portsmouth, Winchester, Salisbury, and the wider Hampshire region.
Expert Assessment Matters
Parotid lumps are common and often benign, but accurate diagnosis is crucial. Early specialist assessment ensures the right investigations, timely treatment, and the best possible outcome.
📞 If you’ve noticed a lump near your jaw or in front of your ear, contact Hampshire ENT Clinics to arrange an expert assessment.