Parotidectomy

A parotidectomy is a procedure that involves removing the parotid gland, which is the largest of the salivary glands, to treat some cases of salivary cancer. The parotid gland is located in front of the ears and is responsible for producing and secreting saliva.

Depending on the patient’s condition, the physician may recommend one of the following types of parotidectomy:

• Superficial parotidectomy involves removing the superficial (or outer part) of the parotid gland. During the procedure, the surgeon makes a cut in front of the ear and down the neck, careful to not harm the facial nerve.
• Total parotidectomy involves removing the entire parotid gland. During the procedure, the surgeon makes a cut in front of the ear and down the neck. Depending on where the tumor is located, the facial nerve may need to be removed, which could affect the ability of the face to move.

Some patients may also need to undergo a lymphadenectomy, which involves removing connective tissue, nerves, muscles and blood vessels.

Patients may need a parotidectomy if:

• The parotid gland has a lump that may or may not be cancerous
• They have pain and swelling from stones in the gland
• Stones have damaged the gland

The potential risks of a parotidectomy include:

• Reaction to anesthesia such as wheezing, rash, swelling and low blood pressure
• Bleeding
• Blood clots
• Infection
• Loss of feeling in the ear
• Dry eye
• Numbness in the lower part of the earlobe
• Facial nerve damage, which may lead to facial muscle loss, facial droop, issues with tongue movement, problems with speech or swallowing, arm weakness and/or weakness in the lower lip
• Frey syndrome, a condition that may cause facial flushing and sweating when eating a meal, or even thinking, dreaming or talking about eating
• Salivary fistula, which is an abnormal opening in the skin that saliva may leak through
• A change in physical appearance

The patient will receive general anesthesia to help relax their muscles and put them to sleep. The surgeon will then make a cut in front of the ear and under the jaw in skin creases so that the cut will be hidden once it heals. All or part of the parotid gland will be removed, depending on the patient’s condition. The surgeon will then close the cut. The entire procedure will take one and a half to three hours.

The patient will stay in the hospital for one to two days after the procedure. A drainage tube will be inserted into the wound to prevent fluid from collecting under the skin. The tube is typically removed after a few days.

One side of the patient’s face will be sore for at least one week and swollen for about three weeks. The patient’s face may be bruised, numb and drooped for three to six weeks after the procedure.

Patients should speak to their physician about:

• How long the recovery will take
• Which activities they should avoid
• How soon they can return to normal activities
• How to take care of themselves at home
• Which symptoms they should look out for and what to do if they have them