Why is parotidectomy done?

Parotidectomy is normally performed to remove a tumor within the parotid gland. Sometimes the nature of the tumor will be known before the operation, however, the surgery is often done to remove the tumor so that the pathologist can examine it.

 

What are the types of parotidectomy?

There are two types of parotidectomy, they are:

• Superficial parotidectomy: in superficial parotidectomy, the parotid gland's superficial (external) part is removed. The surgeon makes a cut/incision in front of the ear and down the neck. This does not often affect the movement of the face, since it attempts to avoid the facial nerve.
• Total parotidectomy: in total parotidectomy, the entire parotid gland is removed. The surgeon cuts in front of the ear and down the neck. Depending on the location of the tumor, the facial nerve and other tissues can be removed. This could affect the movement of the face.

 

The lymph nodes in the neck can be removed in certain cases. This procedure is known as lymphadenectomy. This procedure can require the removal of connective tissue, muscles, nerves, and blood vessels. In order to do this, a long hole is made in the neck.

Each case varies, and the doctor will talk to patients about the specifics of the surgery.

 

How is the surgery performed?

Before the procedure

Before the procedure, the doctor will pre-assess the patients during which they will look at the patients’ medical history and explain the procedure. There are several tests that can be taken before the parotidectomy and they include diagnostic imaging, fine-needle aspiration, neck dissection, and antibiotic prophylaxis.

• Diagnostic Imaging like computed tomography (CT) scans or magnetic resonance imaging (MRI) - they help the surgeons locate the tumor and address complications
• Fine-needle aspiration - the technique that helps surgeons physically diagnose the lethality of the tumor
• Neck dissection - it is considered only in the most severe cases prior to parotidectomy

 

During the procedure

In this operation, general anesthetic is administered to the patient, which means they will be asleep during the procedure. Then the surgeon makes an incision immediately in front of the ear. The incision is extended either downwards into the neck or behind the ear. When the gland is removed, the incision is held together with stitches. The stitches need to be removed around a week after the surgery. At the end of the operation, a small tube is also inserted through the skin into the underlying wound to extract any blood which can accumulate. The tube is normally removed on the morning after the surgery.

 

After the procedure

After the parotidectomy is over, patients can expect one to three days of postoperative hospitalization, which will help ensure that they get the most safest and effective postoperative management. During this time, patients are given antibiotics to reduce their risk of infection as well as to assess the management of pain throughout their stay. The duration of hospitalization varies from patient to patient. Most patients are discharged within 24 hours after surgery is completed. If a tumor is life-threatening, most patients are referred for radiation therapy. Surgery usually provides the complete cure for benign tumors and slow-growing cancers.

 

What are the risks of parotidectomy?

There are risks, as with any surgery; among them are:

• Reaction to anaesthesia
• Bleeding
• Blood clots
• Infection
• Facial nerve damage
• Freys Syndrome
• Loss of sensation in the ear
• Dry eye
• Salivary fistula
• Change in physical appearance

 

Conclusion

Parotidectomy is normally used for the removal of a tumor within the parotid gland. Several tests are conducted to diagnose the tumor. If there are other alternatives other than the surgery, the doctors will discuss it with the patients depending on their condition.