A parotidectomy is a surgical procedure to remove part or all of the parotid salivary gland. A person may require the procedure if they have tumors, recurrent infections, swelling, or blockages in the gland.
The parotid glands are the largest of the three major salivary glands, which produce saliva to help a person chew, swallow, and digest food. The parotid glands sit within the side of the face, in front of and just below the ears. Each parotid gland consists of two parts: the superficial lobe and the deep lobe. The facial nerve runs between both lobes.
If someone experiences issues with the parotid glands, such as recurrent infections, recurring swelling, blockages, and cancerous or noncancerous tumors, they may need a parotidectomy.
A parotidectomy is a type of surgery to remove all or part of the parotid gland. It is typically necessary due to issues such as recurrent infections, blockages, recurring swelling, and tumors.
It is a complex procedure due to the positioning of the parotid glands, which sit within the side of the face next to the earlobe. The facial nerve passes directly through the parotid gland,
There are four types of parotidectomy,
- Total parotidectomy: This refers to the removal of the entire parotid gland while keeping the facial nerve intact. A person may require a total parotidectomy if they have aggressive cancerous tumors, large tumors, tumors within the deep lobe, or an atypical development of blood vessels.
- Radical parotidectomy: This involves removing the entire parotid gland, including the facial nerve. A surgeon would typically perform this type of parotidectomy when a person has facial paralysis or a cancerous tumor involving the facial nerve.
- Partial or superficial parotidectomy: This involves removing a section of the parotid gland while keeping the facial nerve intact. A person may require this type of parotidectomy if they have a noncancerous tumor or if cancer has spread from the lymph nodes to the superficial lobe of the parotid gland.
- Extracapsular dissection: This involves careful dissection of the parotid gland while avoiding the facial nerve to remove small sections. A person may require extracapsular dissection if they have noncancerous tumors.
Evidence suggests the most common reason for a parotidectomy is to remove noncancerous or cancerous tumors. Approximately
Other reasons for a parotidectomy can include blockages, recurrent infections, and recurring swelling of the parotid glands.
There are several ways a person can prepare for a parotidectomy, including:
- avoiding certain medications such as aspirin, ibuprofen, and naproxen for 1 week before the procedure
- not consuming food or drink past the point the surgeon recommends, which is usually 6 hours before the operation
- taking a shower using antibacterial soap the night before and the morning of surgery
- removing any makeup
- only taking medications and supplements the surgeon advises
A parotidectomy takes place under general anesthesia. This means a person will be asleep for the duration of the procedure. It is a complex form of surgery that may take around 2 hours to complete.
Once a person is asleep, the surgeon will make an incision from the front of the ear, down toward the neck, or toward the back of the ear. The surgeon will raise the flap of skin to access the parotid gland. It is essential for the surgeon to have adequate access to this area as it contains many important structures and nerves, such as the facial nerve.
Preserving the facial nerve is an important priority during the procedure. The surgical team usually identifies and protects the nerve during a parotidectomy.
The surgeon will carefully remove all or part of the parotid gland depending on the type of parotidectomy they are performing.
Once the procedure is complete, the surgeon will close the wound with surgical sutures, possibly put a draining tube in place, and apply a compression bandage.
Following a parotidectomy, a person may need to stay in the hospital for 1 to 2 days until the drain is ready for removal. A person will need to keep the wound site clean and dry until it has fully healed.
A doctor may prescribe pain relievers if a person experiences pain.
A person can expect to return to everyday activities, including work, approximately 2 to 3 weeks following a parotidectomy. However, recovery time may vary depending on any complications that arise.
Although a parotidectomy is a complex procedure, a
Removing a cancerous tumor with a parotidectomy can prevent the cancer from growing or spreading to other parts of the body.
Using a parotidectomy to remove a noncancerous tumor can allow a surgeon to perform a biopsy to be sure that the tumor is not cancerous or likely to develop into cancer at a later stage.
Although the results of a parotidectomy are typically positive, there are several risk factors a person needs to be aware of,
- facial paralysis
- blood clots
- a buildup of fluid under the skin
- infection at the incision site
- lockjaw
- Frey’s syndrome, which involves sweating and swelling at the surgical site when a person is eating
- first-bite syndrome, which involves pain in the parotid gland area when someone first starts eating
- sialocele, which refers to saliva leaking via the wound site
A parotidectomy is a surgical procedure to remove part or all of the parotid gland. The procedure may be necessary if a person is experiencing issues with the parotid gland, such as recurrent infections or tumors. The procedure is complex due to the location of the facial nerve, which runs through the parotid gland.
Benefits of a parotidectomy include stopping any cancerous tumors from growing or spreading and treating any recurring infections or swelling. However, there are several potential risks of the procedure, including facial paralysis, blood clots, lockjaw, and sweating while a person is eating.