Your Health

Parotidectomy

(Superficial Parotidectomy; Total Parotidectomy)

Definition

Parotidectomy is surgery to remove all or part of the parotid gland. These glands make saliva. They are located on your jaw, in front of and below each ear.
Salivary Glands
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The parotid gland is the largest of the salivary glands.
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Reasons for Procedure

The surgery is done to:
  • Remove a tumor in the gland
  • Remove lymph nodes that could be cancerous
  • Treat recurrent infections in the gland

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Numbness of the face and ear
  • Damage to the nerve that controls the movement of muscles in your face
  • Saliva drainage—Saliva may pool in the upper neck after surgery. It may also drain through the incision after it has been closed. This is temporary.
  • Frey’s syndrome—This happens when salivary nerve fibers grow into the sweat glands. While eating, some people may notice sweating on the side of the face where the surgery was done.
  • Fistula—This is an abnormal connection that may occur between the mouth, nose, throat, or skin.
  • Infection
  • Bleeding
  • Scarring
  • Swelling of your airway
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

Before the surgery, your doctor may:
  • Do a physical exam and review your medical history
  • Order blood tests and have x-rays taken
  • Talk to you about any medications, herbs, and dietary supplements that you may be taking—You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
Be sure that you have a ride to and from the hospital the day of your surgery.

Anesthesia

General anesthesia will be used. It will block pain and keep you asleep through the surgery. It is given through an IV or nasal mask.

Description of the Procedure

The doctor will make a cut in front of the ear and down into the neck. The nerves in the area will be located and protected during surgery. There are two types of parotidectomy surgery. The type you will have depends on why the surgery is being done.
If you have a tumor and it is above the facial nerve, then a superficial parotidectomy is done. The tumor and affected tissue can usually be removed safely without harming the nerve.
If you have a tumor that surrounds or grows into the facial nerve, a total parotidectomy is done. The tumor, affected tissue, and parts of the nerve are removed.
After all tissue has been removed, the area will be closed with sutures. A drain will be placed behind your ear. It will be used to remove any fluids, such as blood and saliva, from the wound.

How Long Will It Take?

  • Superficial parotidectomy—3-4 hours
  • Total parotidectomy—5 hours

How Much Will It Hurt?

Anesthesia prevents pain during surgery. Pain or soreness during recovery will be managed with pain medication.

Average Hospital Stay

Most will go home the day after surgery, once they are able to eat and walk around on their own. Some may need to stay longer if there are any complications.

Post-procedure Care

At the Hospital
After the surgery is over, you will be moved to a recovery room. The hospital staff will monitor you. The staff may:
  • Check your facial movements by asking you to smile or pout
  • Show you how to care for the drain, because you will have it when you go home
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
At Home
When you return home, do the following to help ensure a smooth recovery:
  • Follow your doctor's instructions for keeping the wound clean. This may include changing bandages.
  • Follow the instructions for caring for your drain. It will usually be removed in 2-4 days.
  • You may also need to return to the hospital to have the sutures removed. This may be in 4-6 days. When the sutures are out, clean the area with mild soap and water.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.

Call Your Doctor

Call your doctor if any of the following occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, a lot of bleeding, or discharge from the surgery site
  • Persistent nausea and/or vomiting
  • Pain that you cannot control with the medications you were given
  • Cough, shortness of breath, or chest pain
  • Spitting or vomiting blood
  • New or worsening symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org

American Cancer Society http://www.cancer.org

CANADIAN RESOURCES

Canadian Cancer Society http://www.cancer.ca

Canadian Society of Otolaryngology http://www.entcanada.org

References

Dictionary of cancer terms: parotidectomy. National Cancer Institute website. Available at: http://www.cancer.gov/dictionary/?CdrID=44770. Accessed July 23, 2013.

Ghorayeb B. Parotidectomy: frequently asked questions. Otolaryngology Houston website. Available at: http://www.ghorayeb.com/parotidectomyfaq.html. Updated May 24, 2013. Accessed July 23, 2013.

Parotidectomy. MedStar Georgetown University Hospital website. Available at: http://www.georgetownuniversityhospital.org/body%5Fdept.cfm?id=1017. Accessed July 23, 2013.

Surgical procedures: neck dissection. Greater Baltimore Medical Center website. Available at: http://www.gbmc.org/body.cfm?id=198. Accessed July 23, 2013.

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