Parotidectomy is surgery to remove the parotid gland. The entire gland can be removed, or only a small part.

Parotid Glands

Parotid glands are salivary glands. They are connected to the facial nerves that control smiling and other facial movements. Humans have two parotid glands. Located under the skin, they are situated over the jaw bone in front of each ear.

Potential Problems

When working properly, parotid glands inject saliva into the mouth to help moisten, lubricate and protect teeth and mucous membranes, which also prevents bacterial growth that could lead to infection. Symptoms that the parotid glands are not functioning properly include pain, swelling, drooling, and dry mouth. If the condition calls for surgery, it could mean there is an abnormal growth in the gland, such as a mass or lump, that needs to be removed. Surgery is also performed when the gland experiences recurrent infections or stones.

Before Parotidectomy

In addition to at least one examination, the physician may order an MRI or CT scan to determine the parotid gland’s anatomy. Fine-needle aspiration (FNA) may be performed if the imaging results show a suspected tumor along the parotid tail. The procedure involves a small needle inserted into the problem area to collect a sample of fluid and cells for diagnosis.

The Surgery

Parotidectomy is performed in an operating room, and the patient is given general anesthesia. A surgeon cuts the skin around the ear, similar to the incision made during a facelift. Once the skin is pulled back from the face, the nerve entering the salivary gland must be identified so that any unnecessary stimulation is avoided. Because this can be challenging, the surgical team may use a facial nerve monitor or other device placed on the patient’s skin that helps identify facial nerves. Once identified, the mass or tumor is carefully removed.

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A partial superficial parotidectomy is when the surgeon only removes the part of the gland surrounding the mass or tumor. To do this, only some facial nerve branches are dissected. When all of the gland is removed, it is a superficial, or lateral, parotidectomy. With the total removal procedure, all facial nerve branches are dissected from the gland. Those branches are totally mobilized, and the deep part of the gland is removed. Cutting into the skin to get at the parotid gland may leave a small defect, but this can be filled in with soft tissue or muscle flaps. When the lesion to be removed is small, doctors can opt for a minimally invasive incision, which can help camouflage scars. Surgical completion time varies based on whether it is a partial or full removal and the location of the tumor.