A parotidectomy is the removal of the parotid gland, which is located on the sides of the face. This is a gland, which is bilateral (you have 2 of them), that is located in the upper area of the neck and lower border of the face, just below the ears. It is the largest and major of the salivary glands, that secretes saliva through a duct inside each cheek from each gland. Typical reasons to remove a parotid gland are due to a tumor, either benign or malignant. In a parotidectomy, the gland is removed with an incision around the face into the neck to help expose the face. Dr. Shah modifies this approach using a facelift technique which places the incision behind the ear to help conceal the location of the incision. In addition, once the gland is removed there is often a defect in volume making the face appear unbalanced. Dr. Shah incorporates the use of muscle flaps to help balance out the facial proportion as well as fat transfer in select cases.
Why Have A Parotidectomy?
The benefits of having a parotidectomy are removal of the tumor or gland. Much like any tumor removal, the spread of tumors from the gland is prevented to the surrounding areas, dependent on the type of removal. Also, facial functions that were affected by problems with the affected gland may return if the tumor is removed in time. If the tumor is malignant and removed, it helps the spread of cancerous tumors in other areas of the body. While commonly benign, it can improve on the aesthetic look of the contour of the face.
What is the procedure for a Parotidectomy like?
The procedure is done under general anesthetic. Dr. Shah, as mentioned earlier, uses a facelift technique that puts the incision behind the ear to help better conceal the location of the incision while keeping in mind to not change the ear’s anatomy and conceal the location of the scar. A incision is made over the surface of the gland to expose the tissue that needs to be removed. After identifying veins and nerve branches, specific nerves are dissected. Monitoring facial nerves is known to reduce nerve-associated complications. This also happens to help prevent any nerve stimulation during the procedure. Once the tissue is removed, nerves are tested for proper function and the reconstruction begins.
Are You A Candidate for Parotidectomy?
Typically, a benign tumor on the parotid gland can be found in people after the age of 40 and has been shown to affect both men and women around this age. The ideal candidate for this type of procedure would be someone who finds a lump in this area, whether the lump is malignant or benign. Not only would this type of surgery help prevent the spread of tumors, it would also improve the patient’s appearance as noticeable protruding bumps are removed. Also, this procedure could help with any patient who is suffering from parotid inflammation ailments such as parotid abscesses, salivary mineral deposits or excessive salivation, to name a few.
The approach to the surgery depends case by case, but typically, a parotidectomy is mainly an in-patient procedure which the patient should expect at least a 24-hour hospital stay (or up to three days) to ensure the best and most effective post-operative care. However, depending on the procedure, a patient could be released the same day. While a benign lump removal usually mean a cure or remission, patients with a malignant tumor are often referred to continue with recovery through radiation therapy, however each case is different.
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Frequently Asked Questions:
What are the risks of parotid surgery?
The risks of parotid surgery are potential nerve injury to the facial nerve as well as sensory nerve to the face. The facial nerve is responsible for movement of the face and is typically dissected to free up the parotid gland. In addition, sensory nerves are near the area of the face and temporary and rarely permanent loss of sensation to the face and ear can occur. In addition, hematoma (collection of blood) and infection are other possible outcomes.
Do I need to have my parotid gland removed?
Discuss treatment options with a surgeon who is an Otolaryngologist to help determine if you are a candidate. Typical reasons for removal of parotid gland include tumor removal.
How do I know if I have a tumor present?
Most tumors which occur are palpable (by feel). If there is a palpable lump which is different on one side from the other within the parotid, further investigation may be warranted.
Can parotidectomy performed on an outpatient basis?
Parotidectomy can be performed in a surgicenter, hospital or as an overnight stay depending on the size and depth of the tumor removed. Most times, patients are able to go home the same day after surgery.
Does insurance cover a parotidectomy?
Yes, insurance should cover a parotidectomy. Every patient’s insurance is different so keep in mind the benefits can vary from person to person as well as individual copay and deductible.
Does insurance cover the reconstruction after parotidectomy?
Yes, insurance typically covers reconstruction after a parotidectomy however every insurance plan is different (BCBS, blue cross blue shield, aetna, united healthcare etc). Even though the type of approach is more technical there is not an additional fee from the insurance company.
Does Dr. Shah participate with insurance?
Yes Dr. Shah (effective 2016) participates with most plans of BCBS (Blue Cross Blue Shield of Illinois) , United Healthcare and Aetna.
Where will the surgery take place?
It depends on the size of the tumor and anticipated type of the tumor if it will take place in a hospital setting versus a surgicenter setting.
Is a parotidectomy painful?
There can be pain associated with a parotid gland removal and depends on the patient in a case by case basis. Since there are sensory nerves in the area, some of which must be cut, regrowth of the nerves in this area can lead to some pain in some patients. However, typically most patients do not have a tremendous amount of pain post procedure.
Are there any risks for this procedure?
With all surgeries, there is always a risk of facial nerve damage since the parotid gland is located near many facial nerves. Dr. Shah is highly skilled with this procedure and monitors every step to prevent this from happening.
Related procedures: Radiesse, Sculptra.