Parotidectomy Surgery in Bangalore

Overview

The parotid gland is the largest salivary gland in the human body. It is located in front of the ear and extends to the jawline. However, sometimes, the parotid gland develops tumors, which can be cancerous (malignant) or noncancerous (benign). It may also develop infections and obstructive salivary stones. Most cases may require surgery (parotidectomy) to remove part or all of the parotid gland. The surgical method depends on the size, type, and location of the tumor. The facial nerve that runs through the gland is carefully dissected as it is crucial to maintain facial movement and expression. 

What To Expect In A Parotidectomy?

Here’s what you can expect before, during, and after a parotidectomy procedure:

Before Surgery (Preparation)

A thorough and careful preparation before a parotidectomy surgery is important to ensure the safety and success of the surgery. The preparatory measures include the following:

• Medical evaluation: The patient is physically examined. His/her medical history is reviewed and any medications s/he is on are adjusted as per the need of the surgery.
• Imaging studies: MRI or CT scans of the head and neck may be done to help assess the location, size, and characteristics of the parotid gland lesion, and plan the procedure.
• Biopsy: A fine needle aspiration biopsy (FNAB) is performed to diagnose the nature of the lesion or tumor.
• Preoperative testing: Blood work, electrocardiogram (EKG), and chest X-ray may be done to assess your overall health.
• Fasting: You will also be told to fast (not eat or drink) for a certain time period right before the surgery to reduce the risk of aspiration during anesthesia.
• Arrange help: Make sure that you arrange for a friend or a family member to drop you back home from the hospital. Also, arrange help at home while you recover.

As the pre-operative instructions can vary from person to person, make sure that you follow the guidelines given to you diligently. 

During Surgery (Procedure Steps)

A parotidectomy operation involves the removal of all or part of the parotid gland. Its specific steps are based on the extent of surgery required and the underlying condition to be treated. Here’s the general framework of a parotidectomy surgery:

• Anesthesia: General or local anesthesia with sedation is administered to the patient to make the procedure pain-free.
• Incision: The surgeon makes an incision in the front of the ear, which extends down to the neck. To reduce scarring, the incision is made following the natural creases of the skin. A more limited incision may be viable for smaller tumors or lesions.
• Exposing the gland and removing the tumor or gland: Now, the parotid gland is exposed. Depending on the reason for surgery, total, superficial, or partial parotidectomy is performed. Tumor removal may be accompanied by the removal of some surrounding structures (healthy tissue) to ensure complete tumor removal.  
• Monitoring the facial nerve: During the whole surgery, the facial nerve passing through the gland is monitored well and dealt with extra care. It is crucial to maintain facial movement and expression.
• Closure: Finally, the incision is closed with sutures or staples. A drain may also be placed in the wound to prevent fluid from accumulating.

After the completion of the parotidectomy operation, the patient is taken to the recovery room, where his/her vitals are monitored until they are stable.

After Surgery (Recovery and Outlook)

The recovery and outlook after a parotidectomy depends on the individual, the presence of complications, and the extent of the surgery. Here’s a general overview of what can be expected post-parotidectomy:

• Immediate postoperative period: 
• Medications are used to manage pain and discomfort arising after the surgery. 
• The drain, if placed, is also to be cared for. 
• Swelling and bruising are also normal at the incision site. 
• Starting with soft foods is recommended and strenuous activities like heavy lifting are prohibited for proper healing.
• Long-term recovery: 
• There can be some weakness or paralysis of the facial muscles, however, it is temporary and subsides after weeks to months. 
• You can gradually return to a normal diet as per the instructions from your doctor.
• Swelling and bruising will subside within a few weeks with proper care.
• The incision scar becomes less noticeable with time and you will be instructed on how to care for the scar. 
• Follow-up appointments are scheduled in order to assess your progress.
• Outlook: Overall, most patients can expect to gradually return to their normal activities within a few weeks to months after a parotidectomy, although complete recovery may take longer.

Share all your concerns or queries with your doctor during your recovery in order to avoid any complications. 

Parotidectomy - Benefits And Risks

As with any surgery, there are certain risks and benefits associated with parotidectomy. Weighing both benefits and risks before the surgery is important to make informed decisions. Here is a list of the potential and possible complications/risks and the anticipated benefits of the operation:

Risks:

• Damage to the facial nerve, resulting in temporary or permanent weakness, asymmetry in facial expressions, or paralysis
• Frey’s Syndrome (gustatory sweating), is characterized by sweating and flushing on one side of the face when eating.
• Salivary fistula, which can occur if there is incomplete closure of the wound or disruption of the ducts that carry saliva leading to the leak of saliva.
• Scarring, infection, and/or bleeding may occur at the surgical site.
• Incomplete removal or recurrence, especially with cancer, necessitating further treatment.

Benefits:

• Effective removal of malignant/benign tumors of the parotid gland.
• Prevention of recurrence and complications, and alleviation of symptoms.
• Help with the diagnosis and treatment of malignant as well as benign conditions.
• Improved quality of life, reduced anxiety, and lesser physical discomfort.

It's important for individuals considering parotidectomy to discuss the potential benefits and risks with their healthcare provider.