Parotidectomy is the surgery to remove the parotid gland. Ahead and neck surgeon performs this surgery.
The period of recovery from parotidectomy varies with each patient. Light exercises and walking are permitted after 2 weeks of surgery for most patients. Many patients may face difficulty in chewing and swallowing for several days after the surgery. This may be due to trauma to the facial nerve; this takes 3-4 months to get better. Swelling over the face and neck resolves in 4-5 days by applying an ice pack to the surgical wound. The numbness in the frontal part of the operated ear may be permanent, but the surgeon is the best person to provide you with definite answers.
While most patients recover completely within 3-4 months, others may take as long as one year.
Why is parotidectomy done?
Parotidectomy is most commonly done for overgrowths or tumors in the parotid gland. Most of these tumors are noncancerous but around 20% are found to be cancerous (malignant). Other conditions for which doctors can resort to parotidectomy include:
- Chronic parotitis (inflammation or infection of the parotid gland)
- Deep salivary calculi (stones in the parotid gland)
- A parotid abscess (pus-filled pockets in the parotid gland)
How is parotidectomy performed?
The parotid gland consists of two lobes: the superficial lobe and the deep lobe. Accordingly, parotidectomy is of two types:
- Superficial parotidectomy: Surgery to remove a tumor in the superficial lobe.
- Total parotidectomy: Surgery to remove a tumor in the deep lobe or both the deep and superficial lobes.
The incision for both types of parotidectomy begins at the front of the ear and follows the line down to the neck and under and along the jawline. The facial nerve lies between the two lobes of the parotid gland. It will be identified, and care will be taken to not damage the nerve. However, there is a chance that the nerve may be affected by the tumor or surgery. After the surgery is completed, the surgeon will check for the functioning of the facial nerve.
What are the risks of parotidectomy?
The tumors detected are usually benign and patients can expect normal function after the surgery. However, complications may arise. The possible ones include:
- Temporary/permanent damage to the facial nerve: Facial nerve may get temporarily or permanently weakened due to the removal of a parotid gland tumor. Loss of facial nerve function can result in partial or total paralysis on one side of the face. The patient may not be able to:
- Raise their eyebrows.
- Close their eyes.
- Bleeding or hematoma (pooling of blood under the skin)
- Frey syndrome (excessive sweating of skin in and around the ear, especially while eating)
- Salivary leakage
- Ear numbness (numbness lessens over time in some patients)
- Facial asymmetry (related to the amount of gland removed and the thinness of the patient)
- Cosmetic deformity
- Recurrent tumor
- Trismus (reduced opening of the jaw)
Surgeons always discuss the benefits and risks of the surgery with their patients before planning the surgery. Patients should also clear any queries, if they have any, before giving their consent for the surgery.
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Marchese-Ragona R, De Filippis C, Marioni G, et al. Treatment of complications of parotid gland surgery. Acta Otorhinolaryngol Ital. 2005;25(3):174-178. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639867/
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