What is Parotidectomy

Parotidectomy is a surgery to remove all or part of a parotid gland. You have two parotid glands, one on each side of your face. These glands make saliva. They are located in front of the ears, near the jaw.

Parotidectomy is sometimes needed when a parotid gland develops an infection or growth (tumor). The facial nerve, which controls movement of the face, passes through the parotid gland. In some cases, infections or growths can affect the function of that nerve.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Scarring.
• Tumor regrowth.
• Temporary numbness or weakness in the face (permanent numbness is rare).
• Partial loss of movement (paralysis) in the face (rare).
• Leaking saliva that collects in the area around the surgical cut (incision).
• A condition that causes sweating from the affected side of the face when you are eating (Frey syndrome). This can develop many months after surgery.

What happens before the procedure?

• You may have an exam or testing.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• You may be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your surgical site will be marked or identified.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins in order to give you fluids and medicines.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• An incision will be made in front of your ear. The incision will curve under your ear and down to your neck.
• Skin and tissue will be lifted so the surgeon can see the parotid gland.
• All or part of the gland will be removed. The surgeon will be careful to protect the facial nerve.
• The incision will be closed with stitches (sutures), skin glue, or adhesive strips.
• A drain may be placed in your neck, near the incision. The drain will let extra fluids, such as blood or saliva, flow out of the wound. This drain will be left in place until drainage decreases.
• A bandage (dressing) may be put over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may continue to receive fluids and medicine through an IV tube.
• You will have some pain. Pain medicines will be available to help you.
• Your health care provider will check movement in your face to see how the facial nerve is working. You may be asked to smile, close your eyes, raise your eyebrows, or move your cheeks.
• You may have a drain in place to let fluids drain from the wound. Typically, the drain will be taken out within 24–48 hours.
• Do not drive for 24 hours if you received a sedative.

Parotidectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have:

• Pain and mild swelling at the site of your incision.
• Numbness along the incision.
• Numbness in part or all of your ear.
• Mild jaw discomfort on the surgical side when you are eating or chewing.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Follow your health care provider’s instructions about cleaning and maintaining the drain that was placed near your incision.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
• If your mouth or jaw is sore, try eating soft foods until you feel better.
• Drink enough fluid to keep your urine pale yellow.

General instructions

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Take short walks every 1–2 hours during the day. Ask for help if you feel weak or unsteady.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
• Keep your head raised (elevated) when you lie down. Try using two pillows to do this. Do this until your incision heals.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that does not get better with medicine.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You vomit or feel nauseous.
• You have a fever.
• Your face sweats or turns red when you eat.

Get help right away if:

• You have pain, swelling, or redness that suddenly gets worse at the incision site.
• You have increasing numbness or weakness in your face.
• You have severe pain.

Summary

• After your procedure, it is common to have pain and mild swelling at the site of your incision.
• Wash your hands with soap and water before you change your bandage (dressing).
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.