A parotidectomy is a surgical procedure that removes part or all of the parotid gland, the largest of the salivary glands, located just in front of the ears. This surgery is typically necessary when a benign or malignant tumor, a chronic infection, or another issue is affecting the gland. If you need a parotidectomy, you probably have many questions. The ear, nose, and throat specialists at North Carolina Specialty Hospital explain what you need to know about the condition, the symptoms, the procedure, and the recovery.

Frequently Asked Questions About Parotidectomy Surgery

What Is a Parotidectomy?

A parotidectomy is a surgical procedure performed to:

• Remove tumors or cysts. The majority of parotid tumors are benign, but malignant growths require removal for further investigation.

• Address chronic inflammation or infection that hasn’t responded to other treatments.

• Treat chronic sialadenitis (infection of the salivary glands).

• Remove non-tumorous lesions or stones within the gland.

What Symptoms Indicate You May Need a Parotidectomy?

• Persistent lump or swelling near the jaw, under the earlobe, or in the neck area. This may be due to a benign or malignant tumor within the parotid gland.

• Pain or discomfort in the area surrounding the parotid gland.

• Numbness or weakness in the face because of an affected facial nerve.

• Difficulty swallowing or breathing because a mass is pressing against the throat or airway.

• Ulceration or skin changes over the gland.

• Persistent salivary gland infections that aren’t responding to antibiotics.

• Unexplained weight loss or fatigue when associated with a lump or the other symptoms listed above.

What Is a Superficial vs. Total Parotidectomy?

• Superficial Parotidectomy: Involves the removal of only the superficial lobe of the gland. This is the more common procedure when dealing with benign tumors and has a lower risk of facial nerve damage.

• Total Parotidectomy: Involves the removal of the entire gland, typically recommended when malignant tumors are present or when extensive tissue removal is necessary.

Each type’s choice depends on the tumor’s nature and position relative to the facial nerve.

What Are the Risks Associated With a Parotidectomy?

Like any surgical procedure, parotidectomy has associated risks, which include:

• Facial nerve injury, which could result in weakness or paralysis of facial muscles since the facial nerve runs through the parotid gland

• Infection

• Bleeding or hematoma

• Salivary fistula, which is when saliva leaks through the wound

• Scarring

Your surgeon will discuss these risks with you, weighing them against the benefits of removing problematic tissue or treating an existing condition.

What Happens During Parotidectomy Surgery?

The patient is administered general anesthesia to ensure they are comfortable and unconscious throughout the procedure.

The surgeon makes an incision, usually starting near the front of the ear and extending downward toward the neck to allow access to the parotid gland. At this time, the surgeon will locate and preserve the facial nerve, which runs through the gland, to prevent facial paralysis.

Depending on the type of parotidectomy, the surgeon will remove either the superficial lobe (superficial parotidectomy) or the entire gland (total parotidectomy).

Once the necessary tissue is removed, the incision is closed with sutures. Sometimes, a small drain may be placed to remove excess fluid and reduce swelling.

How Long Does a Parotidectomy Take?

The surgery typically lasts two to five hours, depending on the extent (superficial or total) of removal.

How Long Does It Take To Recover From a Parotidectomy?

After the surgery, the patient is moved to a recovery area, where they are monitored as they wake up from anesthesia. Recovery involves managing pain, monitoring for complications, and possibly staying in the hospital overnight.

Patients might experience swelling, bruising, or numbness in the area around the incision, which should gradually improve. Follow-up appointments are necessary to monitor healing and discuss pathology results if a tumor or lesion was removed. Physical therapy may also be recommended to aid in facial muscle function recovery if needed.

• In 1-2 Weeks: Patients will likely have follow-up visits for suture or drain removal.
• 3+ Weeks: Most patients can resume regular activities but may need to avoid heavy physical exertion for several weeks.

What Are the Expected Outcomes of a Parotidectomy?

The outcomes largely depend on the initial reason for surgery:

• Benign Tumors: There is typically an excellent prognosis with minimal complications.

• Malignant Tumors: Further treatment, such as radiation, may be required.

• Chronic Infections: A parotidectomy provides significant relief and prevention of further episodes.

How Do I Make an Appointment With a Throat Surgeon?

Meet with one of our board-certified ENT doctors and head and neck surgeons who are specialists in otolaryngology.

Undergoing a parotidectomy operation can provide significant relief and effectively tackle serious health issues associated with the parotid gland. Having a clear understanding of what happens before, during, and after the surgical procedure can aid tremendously in preparing beforehand and helping ensure the most positive results.

North Carolina Specialty Hospital (NCSH) is recognized as a leader in the state for its advanced medical expertise and treatments, compassionate care, and successful patient outcomes. We will be with you for every part of your journey back to health.