Parotidectomy

Parotidectomy is the surgical procedure of removal of a part or the entire parotid gland. It can be divided into two different kinds of surgeries.

• Superficial parotidectomy – Surgery to remove a tumour in the superficial lobe is called a superficial parotidectomy
• Total parotidectomy – Surgery to remove a tumour in the deep lobe or in both the deep and superficial lobes
• Radical Parotidectomy – In addition to the removal of the parotid glands even the facial nerve is removed. Sometimes additional structures like the temporal bone and the skin overlying the parotid gland are also removed where it is referred to an extended parotidectomy.

The most important structure while dealing with parotidectomy procedures is the Facial nerve which runs in between the superficial and deep lobes of the Parotid gland. The facial nerve controls your ability to close your eyes, raise your eyebrows, and smile.
Preserving the facial nerve is an important priority when removing a parotid gland tumour. The facial nerve is typically identified and protected during a parotidectomy. However, there is a chance that the nerve may be adversely affected by the tumour itself or by the surgical procedure needed to remove the tumour.

Neck dissection (cross link to neck dissection) may be required in parotidectomy procedures as cancers often spread via the lymph nodes in the neck (and other nearby tissue). This is usually done  may be done at the same time as the parotidectomy. The goal of this procedure is to remove lymph nodes shown to contain, or that are likely to contain, cancer and to reduce the chance that the cancer may return in the future.

A parotidectomy requires tremendous precision on the part of your entire surgical team. In order to remove a parotid gland tumor, your surgeon will first need to locate and work around the facial nerve.

The complete removal of your tumour, combined with the preservation of the facial nerve, is a priority of the surgical team at SARVASVA HEALTH. Our surgeons have extensive experience in using precise surgical techniques that help preserve the facial nerve.
In some cases, the facial nerve may be temporarily or, very rarely, permanently weakened due to removal of a parotid gland tumor. The risk of facial nerve weakness is directly related to the size, extent, and type of parotid gland tumor.

• Bleeding
• Infection
• Loss of sensation – this will be over the surgical area and will gradually improve over time.
• Seroma – accumulation of fluid under the skin of the neck. This may happen when the surgical drainage tube is removed. This may resolve spontaneously or following aspiration by a needle.
• Sialocoele – accumulation of saliva under the skin of the surgical area. This area will tend to swell during eating. Pressure bandage or in some cases aspiration of the fluid will be required.
• Facial nerve injury – This may occur even though utmost care is taken during the time of surgery. Additional procedures to improve motor function of the face and cosmetic appearance may be required.
• Frey’s syndrome – This is a complication of parotid gland surgery characterized by sweating around the face and neck during eating. This occurs as the nerve endings that stimulated the parotid salivary glands are now in direct contact with the sweat glands of the face and neck.

Loss of facial nerve function related to the treatment of a parotid gland tumor can result in partial or total paralysis on one side of the face. This can greatly impair a person’s ability to make basic movements of the face, such as raising the eyebrows, closing the eyes, or smiling. It can be accompanied by vision loss and, possibly, difficulty eating or speaking. This damage usually occurs in cases where there was a cancer running through it, or in centres where the facilities are not up-to the mark

Our experts have developed highly specialized techniques for treating facial paralysis so people can regain these abilities after treatment. By transferring or transplanting muscles and nerves from other parts of the body or rewiring nerves, our surgeons can restore movement within months. This procedure is known as facial reanimation. It may be done when the tumour is being removed or even years after treatment in some cases.

Depending on the extent of the surgery you may be kept in the hospital under observation for 3 to 7 days
You will be instructed to come back to visit us one week (7 Days) following discharge for a follow up and removal of the sutures.
Mild pain and a degree of numbness around the surgical site is common following parotid gland surgery. However, if you are finding it difficult to wink or close your eyelids, smile or make facial expressions report to us immediately.
Most patients tend to improve gradually and regain full function of the facial nerve after one year.

• Radiation :- usually given in cases the cancer was extremely big or; and adequate excision was not possible
• Chemotherapy – usually not given, unless disease has spread
• Physiotherapy – mainly facial exercise