The parotid glands are salivary glands that are responsible for saliva (spit) production. There are 2 parotid glands (one on each side of the face, in front of and below the ears), as well as 4 other major saliva glands. Parotidectomy is a procedure that is recommended for removal of an abnormal growth in or near the gland, in order to establish the diagnosis and to treat the abnormality. Most tumors within the parotid gland are benign (not cancerous), but removal is still needed to confirm the type of tumor, as well as to prevent complications from continued enlargement.
Surgery is performed under general anesthesia, and it lasts about 2-3 hours. The incision is made in front of the ear and is continued onto the neck, in a natural skin crease. Every effort is made to minimize the scar, but it may be noticeable for several months. There will be a depression below the ear that may be permanent. Depending on the extent of surgery and the type of tumor, the physician may recommend placement of fat (from the abdomen) to reduce the depression.
In order to perform this surgery, the nerve that provides sensation to the lower ear is usually cut. This will result in permanent numbness of the lower ear and part of the upper neck, so caution will be needed to prevent burning the skin (eg with a curling iron).
The most important structure in the area of the parotid gland is the facial nerve, which provides movement and muscle tone to that side of the face. There is potential for this nerve to become stretched, swollen, or injured during surgery. Should this happen, there may be difficulty with smiling, raising the eyebrows, and blinking. While this is usually temporary (1 day-6 months), it may be permanent. Sometimes, the nerve must be cut to properly remove the tumor. If facial weakness should occur, this win be addressed by the physician on an individual basis.
It is unusual, but some patients may develop “sweating” in the surgical area, after eating, that may require additional treatment. This can occur when some of the nerves in the surgical site grow into different areas during the healing process.
Other risks of surgery include bleeding, infection, pain, cosmetic deformity, and the need for further surgery/treatment, as well as risks of anesthesia.
After the surgery, there is a plastic drain placed in the surgical site to prevent buildup of fluid. This is usually removed the day after surgery, but may be left in place for a week, if needed. Most patients stay in the hospital from 1-3 days and will need about 7 days off from work, as well as no strenuous activity for 2 weeks. Care of the incision is usually placement of antibiotic ointment, as directed by the surgeon, for a few days after surgery. Pain medicine and antibiotics (if needed) may be prescribed.
It is important to follow the instructions for preparation prior to surgery and care after surgery, in order to have the best chance for recovery. Please call the office at (972) 402-8404 for questions.