Parotidectomy

Parotidectomy is a surgical procedure that removes all or part of your parotid gland. The parotid glands are important salivary glands. They are located in your cheeks, in front of and beneath your ears. Tumors can develop in the parotid glands. If this occurs, the doctor may perform a parotidectomy to remove the affected portions of the gland.

Parotidectomy is the partial or total removal of the parotid gland for a variety of reasons, including inflammatory conditions, certain infectious processes, congenital malformations, and benign or malignant neoplasms.


Types of parotidectomy

Superficial parotidectomy

The most common type of parotid surgery is superficial parotidectomy. The removal of the parotid gland above the plane of the facial nerve is referred to as a superficial parotidectomy. Small benign tumors that involves only a portion of the superficial lobe may require a "partial" superficial parotidectomy.

Total Parotidectomy

The entire parotid gland involving the superficial and deep lobes is removed. The facial nerve is located in the parotid gland and preserved during this procedure; however, significant dissection is required, which increases the risk of temporary facial weakness when compared to a superficial parotidectomy.

Radical Parotidectomy

This is a total parotidectomy that also includes facial nerve resection. When the facial nerve is involved with the cancer, a radical parotidectomy is performed, and the face is often weak or paralyzed prior to surgery.


Procedure

Before the Procedure

  • An intravenous line is put into a vein in your arm or hand. This line is used to give you fluids and medicines.
  • To keep you free of pain during the surgery, you’re given general anesthesia. This medicine puts you into a deep sleep so you don't feel pain.

During the Procedure

  • The surgeon makes a cut (incision) from the front of your ear to partway down your neck to expose the parotid gland.
  • The facial nerve is located and great care is taken to avoid harming this nerve. A facial nerve monitor (a machine with a small sensor that's put on your cheek) may be used to map the nerve’s exact location. It makes noise when the nerve is triggered. This helps to avoid damage.
  • The parotid gland is removed.
  • If cancer is present, a margin of healthy tissue around the gland is also removed and nearby lymph nodes may also be taken out.
  • The incision is closed with stitches (sutures), surgical glue, or both.
  • A small tube (drain) may be put into the surgical area. This drains blood and fluid that may build up after surgery. The drain will likely be removed before you go home.

After the Procedure

  • You'll be shifted to a recovery room following the surgery to wake up from the anesthesia. You may feel sleepy and nauseated at first. You will be given medicine to control pain. You may then be taken to a hospital room to stay for a day or so.
  • Once you are ready, arrange for someone responsible to drive you home.
  • Have someone stay with you for a few days as your healing begins. If you’re sent home with a drain, you will be shown how to care for it.

Benefits

Parotidectomy can offer several benefits depending on the specific condition being treated. Here are some potential benefits of parotidectomy:

Treatment of tumors

Parotidectomy is commonly performed to remove tumors in the parotid gland, which can be benign (non-cancerous) or malignant (cancerous). By removing the tumor, parotidectomy can effectively treat the underlying condition, potentially preventing further growth or spread of the tumor.

Relief from symptoms

Parotid gland tumors, infections, or stones can cause symptoms such as pain, swelling, facial weakness, difficulty swallowing, and dry mouth. Parotidectomy can alleviate these symptoms by removing the source of the problem.

Prevention of complications

Parotidectomy may be done to prevent potential complications associated with certain conditions affecting the parotid gland. For example, if a tumor is pressing on the facial nerve, which controls facial movements, parotidectomy may be performed to prevent further nerve damage.

Resolution of recurrent infections

Chronic or recurrent infections of the parotid gland, such as chronic sialadenitis, may be difficult to manage with conservative treatments alone. Parotidectomy can remove the gland, preventing further episodes of infection.

Improved quality of life

Relief from symptoms such as pain, swelling, and difficulty swallowing or speaking can significantly improve a patient's quality of life after parotidectomy, especially if they are experiencing discomfort or functional limitations due to their condition.

Diagnosis and staging of tumors

Parotidectomy also allows for the removal of tissue for pathological examination, which can aid in diagnosing the nature and extent of tumors, helping guide further treatment decisions.


Risks

Bleeding (including Hematoma)

Mild bleeding or blood collections under the skin (hematomas) can occur.

Infection

Risk of infection can occur in any surgical procedure. This may necessitate antibiotics and/or infection drainage.

Seroma

There may be collection of normal body fluid in the neck that occurs after the removal of a surgical drain. This can be treated with either observation (because the body usually resorbs it) or repeated needle aspiration to drain the fluid.

Sialocele

Saliva collection under the skin near the surgical site may resolve slowly without treatment or require additional drainage.

Ear numbness

Ear and neck/face skin sensation may be reduced. This area of numbness will fade over time, but the ear lobe may remain numb.

Frey’s syndrome (Gustatory sweating)

Sweating on the side of the face while eating is possible because when the parotid gland is removed, the nerves that normally stimulate saliva secretion can instead innervate sweat glands. Antiperspirant, botox injections, placing a barrier under the skin, or middle ear surgery to cut the nerve that causes gustatory sweating are all options for treatment. Frey's syndrome following a parotidectomy is extremely rare.

Facial nerve injury

Facial nerve injury: The facial nerve, which controls facial movements, runs through the parotid gland and can be at risk of damage during parotidectomy, leading to temporary or permanent facial weakness or paralysis.

First bite syndrome

First bite syndrome is characterized by cramping or sharp pain in the parotid region while chewing. The pain reduces with subsequent bites.

Salivary gland dysfunction

Removal of the parotid gland may result in decreased saliva production, leading to dry mouth (xerostomia) and difficulties in chewing, swallowing, and speaking.


Parotidectomy Care at Medicover

At Medicover Hospitals, we have the most experienced team of otolaryngologists providing exceptional surgical procedures such as parotidectomy to our patients. Our ENT surgeons at Medicover use a multidisciplinary approach to diagnose and treat salivary gland conditions with utmost precision. We provide a wide variety of diagnostic and treatment procedures using the most advanced technologies and world-class equipment, bringing out the best possible outcomes.



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Frequently Asked Questions

1. What is a parotidectomy?

Parotidectomy is a surgical procedure that involves the removal of a parotid gland, which is a major salivary gland located near the ear. It is typically done to treat tumors or other conditions affecting the parotid gland.

2. Why is a parotidectomy done?

Parotidectomy is performed to treat tumors, recurrent infections, stones and facial nerve damage.

3. What are the risks and complications of excision of parotid gland?

Like any surgical procedure, parotidectomy carries some risks and potential complications, which may include facial nerve injury, salivary gland dysfunction, bleeding, infection, scarring and frey’s syndrome.

4. How long does recovery from a parotidectomy take?

Recovery time after parotidectomy varies depending on the extent of surgery, individual health factors, and the reason for the surgery. Generally, it may take several weeks to a few months to recover fully.

5. Are there any dietary restrictions after parotidectomy?

Your surgeon may provide specific dietary instructions based on your individual case, but in general, after a parotidectomy, it may be recommended to eat soft or liquid foods for a period of time, especially immediately after the surgery. Avoiding foods that are hard to chew or may irritate the surgical site, such as spicy or acidic foods, may also be recommended.