The parotid glands lie below and front of the ear. Benign or malignant tumors(cancer) can sprout out in these glands and will present as a lump in front of or below the ear. Most tumors are benign and are present for several months with little or no growth before the patient is referred to a specialist for evaluation. Malignant tumors may cause facial nerve weakness, lymph node enlargement or pain at the site of the tumor. Parotid glands form saliva that drains into the mouth through a duct that lies next to the upper back teeth.
Parotidectomy is performed to remove beigns or cancerous tumors which lie in front of or below the ear. You will have a general anaesthetic and be completely asleep while the operation is done. An incision is made directly to the front or back of the ear and down the jaw line. The skin is folded back to expose the parotid gland. The various facial nerves are located and protected during the surgery so as to avoid permanent facial paralysis or numbness. A superficial or total parotidectomy is then performed, depending on the type and location of the tumor. If the tumor has spread to involve the facial nerve, the operation is expanded to include parts of the bone behind the ear (mastoid) to remove as much tumor as possible. Superficial parotidectomy takes 3-4 hours to complete. Total parotidectomy may take 5 hours to complete. The incision is usually closed with nylon sutures that are removed 4-6 days after surgery. A drain is also placed which exits the wound behind the ear. This is removed in clinic 2-4 days after surgery.
Complications associated with Parotidectomy procedure are:
- Facial nerve weakness
- Frey’s or gustatory sweating syndrome
- Local saliva accumulation or salivary fistula
- Secondary bleeding
- Loss of sensation to the earlobe
Recovery takes on average about two to four months. However, if the swelling in your parotid gland is large, it is possible that during the operation the facial nerve can be seriously damaged or part of it may have required removal to allow for the swelling to come out completely.