Parotidectomy

Why is Parotidectomy Performed?

Parotidectomy is typically recommended for the following reasons:

• Tumors: Removal of both benign and malignant tumors in the parotid gland is a common reason for this surgery. While most parotid tumors are non-cancerous, some may be cancerous and require immediate attention.
• Chronic Infections: If the parotid gland is repeatedly affected by infections that do not respond to conservative treatment, surgical removal may be necessary to prevent further complications.
• Salivary Stones: Large or recurrent salivary stones within the parotid duct can lead to pain, swelling, and blockage of the gland, necessitating surgical intervention.

Types of Parotidectomy:

There are two main types of parotidectomy:

Total Parotidectomy: In this procedure, the entire parotid gland is removed. This approach is often used for extensive tumors or in cases where cancer is suspected.

Partial Parotidectomy (Superficial Parotidectomy): Here, only the affected part of the parotid gland is removed, leaving healthy tissue intact. This method is commonly used for benign tumors or other non-cancerous conditions.

Preparing for Parotidectomy:

Your surgeon will provide specific instructions for preparing for the surgery. These may include:

Fasting: You may be asked not to eat or drink anything for a certain period before the procedure.

Medication: Inform your doctor about any medications, supplements, or herbal remedies you are taking, as some may need to be adjusted or stopped before surgery.

Smoking and Alcohol: It’s essential to refrain from smoking and alcohol consumption before the surgery, as they can interfere with the healing process.

The Parotidectomy Procedure:

The surgery is performed under general anesthesia, meaning you’ll be unconscious throughout the procedure. The surgeon will make an incision in front of the ear, extending into the neck’s creases, to access the parotid gland. The specific technique (total or partial) will depend on your condition.

Preserving the facial nerve is an important consideration when removing the parotid gland. The facial nerve is typically identified first during the operation and constantly kept under vision while dividing the parotid tissue. In rare situations, an aggressive cancer may grow onto the nerve and complete removal of the tumour would be impossible without including some part of the facial nerve. This will result in loss of function (paralysis) of the part of the face supplied by that part of the nerve. Options to restore function will be considered should this be the case.

Recovery and Aftercare:

After the surgery, you will spend some time in the recovery room before being moved to a hospital room. Here are some general guidelines for post-operative care:

Pain Management: Pain and discomfort are common after the surgery, but your medical team will provide appropriate pain medications.

Facial Nerve Monitoring: In some cases, facial nerve monitoring may be used during the procedure to ensure the nerve’s integrity.

Hospital Stay: Depending on the extent of the surgery and your recovery, you may need to stay in the hospital for a day or more.

Facial Exercises: Your healthcare team will guide you through facial exercises to aid in the recovery of facial nerve function.

Diet: You might be restricted to a soft diet initially, gradually transitioning to normal food as advised by your doctor.

Possible Complications:

While parotidectomy is generally safe, there are some potential risks and complications, including:

Facial Nerve Damage: Temporary or permanent facial weakness may occur if the facial nerve is affected during surgery.

Bleeding: Excessive bleeding during or after the procedure is possible but can be managed by your surgical team.

Infection: Like any surgery, there is a risk of infection at the incision site or within the gland.

Numbness: Temporary or permanent numbness in the face or ear area may occur due to nerve disruption.

Follow-up and Prognosis:

Regular follow-up visits with your surgeon will be scheduled to monitor your healing and facial nerve function. The prognosis after a parotidectomy is generally good, with the majority of patients experiencing successful recoveries.

It’s essential to follow your surgeon’s advice and attend all post-operative appointments for the best possible outcome.

Conclusion:

Parotidectomy is a surgical procedure used to treat conditions affecting the parotid gland. It is commonly performed for tumors, chronic infections, and salivary stones. By understanding the procedure, preparing adequately, and following post-operative care instructions, patients can enhance their recovery and improve their chances of a successful outcome. Your healthcare team will provide personalized guidance throughout your journey to better health.