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by Woods M
(Superficial Parotidectomy; Total Parotidectomy)

Definition

Parotidectomy is surgery to remove all or part of the parotid gland. These glands make saliva. They are located in the 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 have cancer
  • Treat infections or frequent inflammation in the gland

Possible Complications

Your doctor will review problems that may happen during or after the surgery such as:

  • Numbness of the face and ear, that may persist
  • 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 between 2 structures.
  • Infection
  • Bleeding
  • Scarring
  • Swelling of your airway

Talk to your doctor about factors that increase the risk of complications, such as:

What to Expect

Prior to Procedure

Before the surgery, your doctor may:

  • Do a physical exam and review your past health
  • Order blood tests and have x-rays taken

Tell your doctor about any medicine, herbs, or supplements you are taking. Some may need to be stopped up to 1 week before the surgery.

Be sure that you have a ride to and from the hospital.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of the Procedure

A cut will be made in front of the ear and down into the neck. There are many nerves nearby. They will be located to decrease the risk of accidental damage.

There are 2 types of parotidectomy surgery. The type you will have depends on why the surgery is being done.

  • Superficial parotidectomy—just the tumor and damaged gland tissue are removed. Nerves are not affected. Can be used if the tumor is above the facial nerve.
  • Total parotidectomy—tumor, damaged tissue, and part of nearby nerve are removed. May be needed if a tumor has grown into the nerve, the gland is infected or inflammed.

After all tissue has been removed, the area will be closed with stitches. A drain will be placed behind your ear. It will allow fluids to drain from wound and help healing.

How Long Will It Take?

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

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. The area will be sore after the surgery. Medicine will help manage discomfort.

Average Hospital Stay

You may be able to go home the same day. You 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 care team will monitor you. The staff will:

  • Check your facial movements by asking you to smile or pout.
  • Show you how to care for the drain.

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

You will need to take it easy for the first few days. Certain actions like strenuous activity will need to be avoided. You will also need to follow care instructions for the drain.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

  • 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

Chronic recurrent parotitis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/topics/dmp~AN~T293145/Chronic-recurrent-parotitis . Updated May 28, 2015. Accessed December 28, 2018.

Salivary gland tumors. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 15, 2017. Accessed December 28, 2018.

Parotidectomy. Memorial Sloan Ketterin Cancer Center website. Available at: https://www.mskcc.org/cancer-care/types/salivary-gland/salivary-gland-cancer-treatment/parotidectomy-parotid-gland-tumor-surgery. Accessed December 28, 2018.

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