What Is a Parotidectomy?
A parotidectomy is surgery to remove all or part of the parotid gland, a gland in your face that helps make saliva. Parotidectomies are used to remove both cancerous and benign (noncancerous) growths from the parotid gland.
Parotidectomies may be used to:
- Remove parotid gland cancer before it spreads to other parts of your body
- Remove cancer that has spread to the parotid gland from another site in your body
- Treat infections
- Treat salivary gland stones, hard deposits that can form in the glands that make saliva
What is the parotid gland?
Your parotid gland is the largest of your salivary glands, which make saliva to help you chew, swallow, speak, and digest. You have three pairs of major salivary glands. The two parotid glands are on the sides of your face, below each ear.
The facial nerve, an important nerve that controls your facial expressions and movements, divides your parotid gland into two halves, or lobes: the superficial lobe and the deep lobe. Protecting your facial nerve is a priority during parotidectomies.
Types of Parotidectomies
If you have a tumor in the parotid gland, you’ll probably need surgery to remove it, whether it’s cancerous or noncancerous.
“Because it’s in such a sensitive region, the general recommendation is to remove any growth,” says Omar Karadaghy, MD, an oncologist and head and neck specialist with the University of Kansas Health System.
Most people are diagnosed after noticing an unusual bump on their face. Many men discover it while shaving, he says. Some masses are caught during imaging for other issues.
There are a number of reasons you may develop an abnormal growth in the parotid gland. Your surgeon will use imaging and a biopsy to get more information about the mass to find the best surgical approach to remove it. The type of parotidectomy you’ll get depends on what part of the gland is affected.
The two most common types are superficial and total parotidectomies.
Superficial parotidectomy
A superficial parotidectomy is a surgery to remove a tumor in the superficial (top) lobe.
Total parotidectomy
A total parotidectomy is a surgery to remove a tumor from the deep lobe or from both the deep and superficial lobes.
Radical parotidectomy
A radical parotidectomy is surgery to remove part or all of the parotid gland. It involves cutting into the facial nerve. It’s the rarest of the parotidectomies and is generally done only when cancer has spread to the facial nerve.
After a radical parotidectomy, part of your face may be paralyzed. In many cases, it’s temporary, but sometimes, it’s permanent.
What Are the Steps Involved in a Parotidectomy?
If you’re considering a parotidectomy, you’ll start by meeting with your doctor. You may get imaging tests and a biopsy to find out more about any growth in your parotid gland. These tests can also help find out what kind of parotidectomy you’ll need.
Your surgeon will develop a treatment plan based on whether you have a cancerous or noncancerous mass.
Make sure you stop eating and drinking before midnight the day of your surgery. Have a friend or family member on standby to pick you up from the hospital afterward.
What happens during the procedure?
You’ll be under general anesthesia for the procedure. Your surgeon will make an incision to get to the parotid gland and remove the growth or tumor, while working to protect your facial nerve. They’ll then close the incision and insert a small tube, known as a surgical drain, for any blood or other fluids that gather around your wound. The whole procedure may last between two and four hours. Many people go home the same day.
What’s the Recovery Like After a Parotidectomy?
You may feel tired after getting surgery, and you may need extra rest for the first couple of weeks afterward.
If you get a partial parotidectomy, you might have moderate pain and feel more fatigued after the procedure, Karadaghy says. Your surgeon may limit how much you can lift for the first two weeks.
Whether you get a total or partial parotidectomy, you’ll need to take care of the wound at home. This includes keeping the incision site clean and dry. You may need to apply antibiotic ointment or petroleum jelly to your stitches. Your medical team will give you instructions for managing your wound.
You may also need a drain to collect fluids from the site of your surgical wound. Your medical team will teach you how to empty the drain at home.
At some point, your doctor will ask you to come back so they can take out the drain and any stitches.
How long does it take to recover from a parotidectomy?
How long it takes to recover depends on how complicated your surgery was. If you get a partial parotidectomy, you’ll probably feel better within one to two weeks. If you get a total parotidectomy, your recovery will last a bit longer, generally around four weeks.
Most people can resume normal activities within two weeks. But if you have facial numbness or weakness, it may take a few months or a year to get better.
Facial exercises after a parotidectomy
Your doctor might recommend facial exercises for recovery after a parotidectomy, especially if you’re dealing with facial weakness, Karadaghy says.
“You can work with a physical therapist who specializes in facial nerve exercises,” he says. “Facial exercises generally revolve around regularly emphasizing facial motion, looking in the mirror, and working on engaging your facial muscles in various ways.”
Facial nerve reconstruction after a parotidectomy
If you’re getting a radical parotidectomy in which your surgeon expects to cut into the facial nerve, they’ll be prepared to do a facial nerve reconstruction during your surgery (or work with a colleague who specializes in facial nerve reconstruction), Karadaghy says. The techniques your doctor uses will depend on how much nerve damage you have.
Parotidectomy Complications
A parotidectomy is a safe procedure. But like with any surgery, there are risks. Possible complications of a parotidectomy include:
- Pain and swelling
- Bleeding
- Infection
- Redness
- Sore throat
- Facial nerve injury
- Temporary facial weakness or numbness
- Salivary fistula, when saliva temporarily leaks through the site of your incision
- Frey’s syndrome, a rare complication that causes sweating when eating
- First bite syndrome, a rare complication that causes pain during the first bite of a meal
If your growth was cancerous, there’s also a chance the cancer could come back (called tumor recurrence). Contact your doctor if you:
- Have facial numbness or weakness
- Notice pus, blood, or other fluid coming from the surgical wound
- Have pain that doesn’t go away
- Notice your surgical wound smells bad or feels warm or painful to the touch
Takeaways
A parotidectomy is when you need surgery to remove all, or part, of your parotid gland, which is your largest salivary gland. This procedure is most often used to remove a cancerous or noncancerous tumor from your parotid gland. Your surgeon will protect your facial nerve during a parotidectomy. Most people make a full recovery after a parotidectomy, generally within two to four weeks.
Parotidectomy FAQs
Here are some commonly asked questions about getting a parotidectomy.
Is a parotidectomy a major surgery?
A parotidectomy is considered a major surgery because it involves removing part, or all, of your parotid gland.
What is the most common complication of a parotidectomy?
The most common complication of a parotidectomy is temporary facial paralysis. Like other surgeries, parotidectomies also have risks like:
- Bleeding
- Pain
- Infection
How serious is a parotid tumor?
How serious a parotid tumor is depends on your situation, since they can be noncancerous or cancerous.
