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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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

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.

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

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

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

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