The parotid gland, along with some other glands makes saliva. You have two parotid glands, one on each side of your face lying in front of your ears. The main reason for operating on the parotid gland is because of the development of a lump within it. Sometimes the gland is operated on because it is not working normally and is causing pain when you eat.
Lumps (tumours) occur in the parotid due to abnormal overgrowth of some part of the salivary glands. Most tumours of the parotid gland not cancerous (benign) and do not spread to other parts of the body. Rarely, cancerous (malignant) tumours can also affect the parotid.
If you develop a lump in your parotid gland then it should be investigated to find out what type of tumour it is. The first investigation is usually an ultrasound scan. If a tumour is confirmed then a needle is put into it to remove some cells for examination which will usually give the diagnosis. Mr Fish will arrange these tests for you.
A parotidectomy is an operation to remove part or all of the parotid gland. If there is a cancerous growth then this may form part of the treatment. Even though 80% of these lumps are benign there are still good reasons to remove them. Generally the benign lumps continue to grow and may become unsightly. There is a very small chance that they can become cancerous in some cases. By removing the lump a definite diagnosis can be made and the larger the lump is the more challenging the operation may be to remove it
The operation is performed under general anaesthetic which means that you are asleep throughout. An incision (cut) will be made which runs from in front of your ear and down into your neck. This incision tends to heal very well and in time the scar is likely to be minimal. At the end of the operation Mr Fish will place a drain (plastic tube) through the skin in order to prevent any blood clot collecting under the skin. This is usually removed the next day so most patients will require an overnight stay in hospital.
Numbness: The skin on the side of the face and the ear will be numb afterwards. This susally recovers but may take many many weeks to do soa and may not completely return to how it was prior to the surgery, particularly over the ear. This is very rarely something the people find troublesome.
Bleeding: Sometimes the drain can become blocked and blood collects in the operation site and causes swelling. Occasionally this requires a second operation to remove the blood clot and replace the drain.
Facial nerve weakness: There is an important nerve, the facial nerve, which passes right through the parotid gland. This makes the muscles of the face move and if it is damaged during the surgery can lead to a weakness of the face (facial palsy). In most cases the nerve works normally after the surgery. However sometimes where the tumour has been very close to the nerve, a temporary weakness of the face can occur that can last for a few weeks hours, days or weeks. In less than 1% of cases there is a permanent weakness of the face following this sort of surgery for benign tumours
Salivary leak or collection: Occasionally you can leak saliva through the wound following the operation. This is nothing to worry about and in the vast majority of cases settles without any intervention over the following few days or weeks. There can also be a collection of saliva or serous fluid (seroma) which can cause the area to swell after theoperation. This may need to be drained with a needle in clinic and may need to be done on more than one occasion.
Freys syndrome: Some patients find that after this surgery the skin in the operated area can become red, flushed and sweaty whilst eating. This is because the nerve supply to the gland can regrow to supply the sweat glands of the overlying skin, instead of the parotid. This usually requires no treatment but if it does then antiperspirant can be helpful.
If the tumour is benign then it is very unlikely that you will need further treatment although even benign tumours can recur. If it is a cancerous tumour then you may need further treatment.
You will need two weeks off work