parotidectomy


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Related to parotidectomy: parotid gland

Parotidectomy

 

Definition

Parotidectomy is the removal of the parotid gland, a salivary gland near the ear.

Purpose

The main purpose of parotidectomy is to remove cancerous tumors in the parotid gland. A number of tumors can develop in the parotid gland. Many of these are tumors that have spread from other areas of the body, entering the parotid gland by way of the lymphatic system. Among the tumors seen in the parotid gland are lymphoma, melanoma, and squamous cell carcinoma.

Description

The parotid gland is the largest of the salivary glands. There are two parotid glands, one on each side of the face. They lie just in front of the ears and a duct runs from each to the inside of the cheek. Each parotid gland has several lobes. Surgery is recommend as part of the treatment for all cancers in the parotid gland. Superficial or localized parotidectomy is recommended by some authorities, unless a lipoma or Warthin's tumor is present. One of the advantages to this approach is that nerves to facial muscles are left intact. Many facial nerves run through the same area as the parotid gland and can be damaged during more complete parotidectomies. Most authorities recommend total parotidectomy, especially if cancer is found in both the superficial and deep lobes of the parotid gland. If the tumor has spread to involve the facial nerve, the operation is expanded to include parts of bone behind the ear (mastoid) to remove as much tumor as possible. Some authorities recommend post-surgery radiation as follow-up treatment for cancer.

Aftercare

After surgery, the patient will remain in the hospital for one to three days. The site of incision will be watched closely for signs of infection and heavy bleeding (hemorrhage). The incision site should be kept clean and dry until it is completely healed. The patient should not wash their hair until the stitches have been removed. If the patient has difficulty smiling, winking, or drinking fluids, the physician should be contacted immediately. These are signs of facial nerve damage.

Risks

There are a number of complications that follow parotidectomy. Facial nerve paralysis after minor surgery should be minimal. During surgery, it is possible to repair cut nerves. After major surgery, a graft is attempted to restore nerve function to facial muscles. Salivary fistulas can occur when saliva collects in the incision site or drains through the incision. Reoccurrence of cancer is the single most important consideration for patients who have undergone parotidectomy. Long term survival rates are largely dependent on the tumor types and the stage of tumor development at the time of the operation.
Other risks include blood clots (hematoma) and infection. The most common long-term complication of parotidectomy is redness and sweating in the cheek, known as Frey's syndrome. Rarely, paralysis may extend throughout all the branches of the facial nervous system.
Parotidectomy is a surgical procedure performed to remove cancerous tumors in the parotid gland, a salivary gland near the ear. Among the tumors seen in the parotid gland are lymphoma, melanoma, and squamous cell carcinoma. The illustration above shows the facial incision sites for this procedure.
Parotidectomy is a surgical procedure performed to remove cancerous tumors in the parotid gland, a salivary gland near the ear. Among the tumors seen in the parotid gland are lymphoma, melanoma, and squamous cell carcinoma. The illustration above shows the facial incision sites for this procedure.
(Illustration by Electronic Illustrators Group.)

Key terms

Fistula — An abnormal opening or duct through tissue that results from injury, disease, or other trauma.
Salivary gland — Three pairs of glands that secrete into the mouth and aid digestion.

Resources

Books

Bentz, M. L. Pediatric Plastic Surgery. Stamford: Appleton & Lange, 1998.

parotidectomy

 [pah-rot″ĭ-dek´to-me]
excision of a parotid gland.

pa·rot·i·dec·to·my

(pă-rot'i-dek'tŏ-mē),
Surgical removal of the parotid gland.
[parotid + G. ektomē, excision]

parotidectomy

(pə-rŏt′ĭ-dĕk′tə-mē)
n. pl. parotidecto·mies
Surgical removal of the parotid gland.

parotidectomy

Surgery The surgical removal of a parotid gland

pa·rot·i·dec·to·my

(pă-rot'i-dek'tŏ-mē)
Surgical removal of the parotid gland.
[parotid + G. ektomē, excision]
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References in periodicals archive ?
Superficial parotidectomy was undertaken during the early period of the study (during 1998 and 2003) because of diagnostic uncertainty and for cosmesis.
Right total parotidectomy with facial nerve preservation and primary closure was carried out successfully.
Treatment of choice for parotid gland tumours is parotidectomy preserving the facial nerve.
Distribution of surgical approaches to tumor resection and facial reanimation Approach n (%) Transparotid (n = 128) Parotidectomy w/neck dissection 55 (43) Parotidectomy w/petrosectomy 52 (41) Parotidectomy alone 21 (16) Transtemporal (n = 93) Translabyrinthine 43 (46) Retrosigmoid 30 (32) Middle fossa 7 (8) Temporal bone resection 7 (8) Combination 6 (7) Facial reanimation (n = 221) * Interposition graft 65 (29) Microvascular free flap 62 (28) Primary end-to-end repair 45 (20) Split 12-7 anastomosis 42 (19) None 7 (3) * Only 214 of the 221 patients (97%) underwent facial reanimation.
Superficial parotidectomy was done in all the cases and specimen was sent for histopathology.
Parotidectomy: ten-year review of 237 cases at a single insti- tution.
The superficial parotidectomy was done in piecemeal as the mass was unexpectedly adherent to the skin and underlying fascia (Figure 3).
For this retrospective study, we searched our records to identify all patients who had undergone a parotidectomy at the University of Alabama at Birmingham (UAB) Hospital for the treatment of MCC over a period of 10 years and 9 months.
After confirmation of diagnosis during management, Superficial Parotidectomy was the commonly followed procedure for salivary gland tumour in this study (52.5% cases) followed by total parotidectomy (20%).
The incidence and management of sialocele after parotidectomy. Otolaryngol Head Neck Surg.2009; 140:871-4.
Treatment was by local enucleation, superficial parotidectomy and total submandibular gland excision.
All patients underwent surgical resection in the form of a parotidectomy. One patient with OEMCa received radiation therapy.