Reconstructive Plastic Surgery

Parotidectomy

The parotid gland is also known as your saliva gland. These glands are found in the cheek, in front of and below the ear. The facial nerve, which helps with facial movement, also goes through the parotid gland.

During a parotidectomy, part or all of the parotid gland is removed. It’s typically performed to remove a tumour.

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Why is a parotidectomy performed?

A parotid gland (saliva gland) may need to be removed if:

  • A benign or cancerous tumour or lump develops in the parotid gland.
  • You are experiencing painful swelling and reoccurring bacterial infections caused by stones in the ducts that transport the saliva from the gland mouth.

How are Tumours Removed During a Parotidectomy?

A superficial parotidectomy is undertaken to treat tumours and is completed under general anaesthetic.

During a parotidectomy, a surgeon begins by making a cut from in front of and below the ear. The surgeon will locate the facial nerve, which passes right through the middle of the parotid gland.

Using a nerve monitoring device, the surgeon carefully follows the nerve through the gland so not to damage it. This nerve controls the muscles that allow you to smile and frown, blink and close the eyes and close the lips.

Part or all of the gland is removed, depending on its condition, and the surgeon stitches up the incision and a drain is inserted.

Benign parotid tumours must be completely removed. In more serious cases, the facial nerve will also need to be removed, causing permanent weakness of the facial muscles – also known as facial palsy.

Radiotherapy may follow when cancer is present in the parotid gland, as well as outpatient follow-up.

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Recovery and Rehabilitation

You will be able to move around soon after the operation and you will be home within one to two days.

You may need to have stitches removed after a week. You will be provided with post-operative care instructions that include keeping the wound dry and the dressing on for at least seven days. Be gentle with  the site of the surgery and don’t apply heat packs. Smoking should be avoided.

Scarring is usually inconspicuous after this operation.

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Notify the RPS team immediately if you experience any of the following symptoms:

  • nausea, vomiting or diarrhoea
  • fever/high temperature – 38°C or higher
  • shortness of breath
  • leakage of blood or fluid after day one of recovery
  • increasing pain around the site
  • increasing redness around incision site
  • heavy bleeding from incision site.
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More information

What else you should know

How do doctors test parotid glands?

Testing methods to detect lumps in parotid glands include:

  • An ultrasound to check the size, shape and location of lumps or stones.
  • An guided ultrasound and a sample to analyse the lump and report if it is benign or cancerous. It’s similar to a blood test, but the needle goes into the lump to draw out cells to be analysed.
  • A CT scan of the neck and chest is required in some cases.
Will a parotidectomy cause a dry mouth?

No, there is a parotid gland on both sides of the face, as well as other saliva glands, big and small. Removing one parotid gland won’t cause a dry mouth.

How much time will I need to recover?

We recommend taking two weeks off to recover. In the first 24 hours after surgery it’s not recommended to drive, operate heavy machinery or make major decisions.

Are there risks or complications?

Risks and Complications

Facial nerve damage

As the facial nerve runs through the parotid gland, parotidectomy is a delicate procedure and it’s not possible to guarantee the nerve won’t be damaged.

If the nerve is damaged, it can result in complete or incomplete paralysis, affecting some or all of the facial muscles. Six out of 100 people experience temporary weakness in some of the muscles after a parotidectomy and it can last up to one year.

One out of 100 people experience permanent weakness in muscles on one half of their face. The muscles can’t be repaired, however there are procedures that help the eye to close and help the face look more symmetrical.

Other temporary side effects: 

  • Numbness around the wound and ear – will normally subside after six months.
  • Sialocoele – patients may develop a collection of saliva under the skin within one to two weeks of surgery. This can be remedied with a pressure device, or it can be aspirated by a needle.
  • Bleeding – if you have bleeding within 24 hours of surgery, additional surgery may be required to seal the blood vessel.
  • Red or hot wound – infection can occur around the site of the surgery.
  • Blood clots – deep vein thrombosis is a rare condition that can be prevented by using compression devices on the legs and injections of medication.

Other permanent side effects

  • Permanent numbness.
  • Unattractive scarring that needs further surgery.
  • Frey’s Syndrome – a rare condition that causes sweating on the side of the face when eating. In mild cases it can be tolerated, otherwise in more severe cases injections can stop sweat glands from working.
How will the RPS team manage my post-operative care?

RPS will give you specific advice regarding your individual post-operative recovery. They will advise:

  • where you will go after your surgery
  • what medication you will be given or prescribed
  • what bandages and dressings you will need and when they’ll be removed
  • if you require stitches, when they’ll be removed
  • when you can get back to normal activity and exercise
  • when to book your follow-up care.

Dr. Michael Findlay

Our Melbourne specialist

The team at RPS Melbourne are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Dr Michael Findlay holds an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.