Parotidectomy

You have 2 parotid glands. One is on each side of your face, in front of your ears. Parotid glands make spit (saliva). Sometimes, the parotid glands develop infections or growths (tumors) which can block the flow of saliva from the gland. This can cause swelling. Sometimes, tumors can get in the way of the facial nerve that passes through the parotid gland. In some of these cases, parotidectomy is necessary. Parotidectomy is surgery to remove all or part of a parotid gland.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

Usually, problems do not develop after a parotidectomy. However, they can occur. Possibilities include:

  • Infection.

  • Bleeding.

  • Scarring.

  • Numbness or weakness in the face. If this does develop, it usually gets better in a few months. Permanent numbness or weakness is rare.

  • Leaking saliva. It can collect in the wound area and leak through the surgical cut (incision). This can happen after the drain has been taken out. It can happen after the stitches are gone, too. It usually clears up on its own.

  • Frey's syndrome. With this condition, sweat develops on the face when you eat. This can happen if nerves from the parotid gland grow into some of the sweat glands on the face. It may not show up until about 6 months after surgery.

  • Tumor regrowth.

BEFORE THE PROCEDURE

  • A medical evaluation will be done before the parotidectomy. This may include:

  • A physical exam. This will include questions about your health.

  • Blood tests.

  • Talking with the person in charge of giving you medicine that keeps you from feeling pain during your procedure (anesthesiologist). For a parotidectomy, usually you will receive medicine that makes you sleep (general anesthetic). Ask the anesthesiologist or your surgeon what to expect.

  • The day before the surgery, eat only a light dinner. Do not eat or drink anything for at least 8 hours before the surgery. Ask your caregiver if it is okay to take any needed medicines with a sip of water.

PROCEDURE

How long the surgery will take depends on what is being done. It often lasts 3 to 4 hours if just part of the gland is being removed. It could take up to 5 hours if the whole gland is taken out.

  • Your heart rate, blood pressure, and oxygen level will be monitored.

  • A needle attached to a plastic tube (intravenous [IV] line) will be inserted in your hand or arm. Medicine and fluids will be able to flow directly into your body through the IV line.

  • You might be given medicine to help you relax (sedative).

  • You will be given an anesthetic.

  • The area of your face near the parotid gland will be cleaned with a germ-killing solution.

  • Once you are asleep, the surgeon will make an incision in front of your ear. Usually, the incision curves under the ear and down to the neck.

  • Skin and tissue are lifted so the surgeon can see the parotid gland.

  • The gland, or part of it, is removed. The surgeon will be careful to protect the facial nerve.

  • The surgeon will close the incision with stitches (sutures).

  • Sometimes, a drain is placed at the bottom of the incision. It is attached to a small plastic container, shaped like a bulb. This lets extra fluids, like blood or saliva, flow out of the wound and into the bulb. It will be taken out once the wound has healed.

  • Medicine and a bandage (dressing) may be put over the incision.

AFTER THE PROCEDURE

You will stay in a recovery area until the anesthesia has worn off.  Your blood pressure and pulse will be checked frequently. Then you will be taken to a hospital room. You may continue to get fluids through the IV line for a while. Some pain is normal. You may be given pain medicine in the recovery area. Be sure to tell your caregivers if the pain gets worse. Your caregivers will check movement in your face. They may ask you to smile or move your cheeks The drain and bulb will stay in place for a while, even after you go home. Most people stay in the hospital for about 1 day after surgery.