Parotidectomy

Parotidectomy, is the surgical removal of the parotid gland. Depending on the pathology, part or all of the gland is removed.

What is the parotid gland?

The parotid gland is the largest salivary gland. There are two parotid glands on the right and left and are located in front of and below each ear respectively. Their functional role is to produce saliva, which is passed through a duct into the oral cavity.

What operations can be performed on the parotid gland?

Types of parotidectomy:

• Superficial parotidectomy: the outer part of the parotid gland is removed. This part is located above the facial nerve.
• Total parotidectomy: the entire parotid gland is removed after identification and careful preparation of the facial nerve.
• Parotidectomy with cervical lymph node dissection: depending on the extension and pathology of the tumor, parotidectomy can also be combined with lymph node dissection.

What are the indications for parotidectomy?

The indications for surgery are as follows:

• Removal of benign tumors: These tumors must be removed because they usually have a tendency to expand, press on the surrounding tissues, while in a small percentage they can mutate (develop into malignancy). Benign tumors usually constitute 80% of parotid tumors.
• Removal of malignant tumors: Pre-operatively, a fine-needle biopsy must always be performed through the tumor in order to identify it.
• Chronic sialadenitis: For the treatment of diseases that cause partial or complete obstruction and in the drainage of saliva, despite medication.

How is the surgery performed?

The operation lasts from 1 to 3 hours depending on the severity of the condition. In all parotidectomy operations, a special neurostimulator is used to detect the facial nerve and avoid injury to it. A drain is always placed, which is removed after 1 to 2 days postoperatively.

The patient leaves the Clinic the same or the next day. Oral antibiotics are administered for 7 days and painkillers if required. The sutures are removed on the 7th postoperative day.

What are the complications of the operation?

• Injury to a branch of the facial nerve (numbness or temporary inability to move certain facial muscles)
• Serious injury and/or transection of a branch of the facial nerve. In these cases, permanent paralysis (paresis) of the specific facial muscles occurs
• Hemorrhage. It is usually minor and occurs during the first hours postoperatively. Most often it stops with a pressure bandage. Rarely, re-operation is required to investigate the vessel and hemostasis.
• Numbness in the area around the ear and cheek. The numbness is restored automatically after a few days or even weeks.
• Frey syndrome. Redness and sweating in the parotid area appear while chewing food. This is due to a nerve disorder and damage to the peripheral nerves.
• Salivary fistula
• Contamination of the surgical wound

What are the postoperative instructions?

The patient receives oral antibiotics for a period of 7 days and painkillers if necessary.

It is advisable to avoid acidic, sweet and spicy foods and alcohol consumption for a short period.

Avoid weight lifting and intense sports activity for at least 15 days postoperatively.

Avoid travel by plane for two weeks.