A Complete Guide To Parotidectomy Suregry.

: Admin : 2022-02-26

What exactly is a parotidectomy?

A parotidectomy is a surgical procedure that removes the parotid gland. The biggest of the salivary glands in the parotid gland. It is located in front of the ears. The parotid gland is in charge of producing and secreting saliva. Saliva is necessary for food digestion, eliminating germs in the mouth, and avoiding tooth decay.

Salivary gland tumours often begin in the parotid gland. They are uncommon, and the majority of parotid tumours are benign (not cancerous). Some forms of salivary cancer may need a parotidectomy. It may also be used to treat non-cancerous disorders such as persistent infection or salivary gland obstruction (blockage).

How is a parotidectomy performed?

There are two forms of parotidectomy: surgical and non-surgical.

The superficial (outside section) of the parotid gland is removed during a superficial parotidectomy. A cut (incision) is made in front of the ear and down the neck by the surgeon. Because it seeks to avoid the facial nerve, this seldom affects how the face moves.

Total parotidectomy involves the removal of the whole parotid gland. A cut is made in front of the ear and down the neck by the surgeon. Depending on the location of the tumour, the facial nerve and other tissues may need to be removed. This may limit your ability to move your face.

Lymph nodes in the neck may need to be removed in certain circumstances. This is known as a lymphadenectomy. It is possible that connective tissue, muscles, nerves, and blood arteries will have to be removed. A lengthy incision (cut) is made in the neck to accomplish this.

Each situation is unique, and your physician will discuss the details of your procedure with you.

Before the Procedure

There should be nothing to eat or drink after midnight the night before the surgery. If you do not follow these guidelines, you will be unable to have the procedure.

Please notify your doctor of any drugs and dosages (including insulin) you are taking, as well as any allergies you may have. You will be told which drugs you may take with a sip of water on the day of the procedure.

Please avoid aspirin and aspirin-containing products a week before surgery.

Before surgery, remove any make-up, jewellery, nail polish, and artificial nails.

After your surgery, you will be admitted to the hospital for one to two nights for observation.

Following the Procedure

You may anticipate having an incision and a drainage tube in place after surgery. The drain may be removed the next day. Most people find the drain removal as uncomfortable rather than painful. There is a possibility that you may have numbness, tingling, or diminished sensation around the surgery site, as well as the side of your face, neck, and lower ear on the affected side. This should be a one-time occurrence that will resolve on its own. Your doctor will inform you whether the procedure has any long-term effects on the facial nerve.

Sleep with your head up at least 30 degrees when you lay down. Using two to three pillows for one week is a simple method to do this. For the first 2-3 weeks, or as instructed, avoid any severe exercise (bending, lifting, straining, or aerobic activity). There will be no running, aerobics, swimming, or weight lifting.

Avoid drinking or eating overly hot drinks or foods. You might anticipate discomfort during chewing, therefore you should eat softer foods. To avoid dehydration, drink as many liquids as possible. As tolerated, progress the diet from liquids to soft foods.

Wound Care: As previously stated, there will be a drain in place. Once the drainage has subsided, the drain will be removed. Over the incision, a dressing will be applied. Please keep the incision clean and dry at all times. Examine your incision for any symptoms of infection. Infection symptoms include redness, pain, swelling, warmth at the location, and any pus-like discharge.

Medication: You may be in pain. Use your pain medicine as advised and as required for pain relief. If the pain medication does not alleviate your discomfort, please inform our office. Take your medication exactly as prescribed. Do not use aspirin, ibuprofen, or other blood-thinning medications unless your doctor instructs you to.

Follow-up:  It will be around two weeks after your procedure.

What to Expect

The patient will most likely be requested to come to the hospital a few hours before the planned procedure on the day of surgery. During this time, nurses will check the patient in and anesthesiologists will make sure everything is in order for general anaesthesia. In addition, the surgeon will visit the patient to go over the plan and answer any last-minute issues.

For this surgery, the patient will be totally sedated using a general anaesthetic. In certain situations, the surgeon may choose to employ a particular facial nerve monitor, which emits a noise when the facial nerve is activated.

At the completion of the operation, the surgeon may insert a tiny, temporary drain through the skin to remove any fluid and/or blood that has accumulated in the area where the surgery was conducted. The surgical team will remove this drain in 1-2 days.

Aftercare & Recovery

The length of recuperation will be determined by the degree of the surgery and rebuilding. Some procedures may allow a patient to go home after a few hours of monitoring in the recovery room, whilst others may need a stay in the hospital for up to a week. The patient should be able to drink and eat within a few hours after the procedure. This technique normally causes very little discomfort. When physicians assess that a patient no longer requires in-patient treatment, they are ready to be discharged.

Risks

Bleeding, including hematoma: If there is significant bleeding after the surgery, the surgeon may need to return the patient to the operating room immediately to control the bleeding. However, there may be some moderate bleeding or tiny blood deposits beneath the skin (hematomas).

Seroma: A seroma is an accumulation of normal bodily fluid in the neck caused by the removal of a surgical drain. This may be treated with either observation (since the body will generally resorb it) or repeated needle aspiration to empty the fluid.

Infection: Any surgical operation has the danger of infection. This may need antibiotics and/or infection drainage.

Sialocele: This is a collection of saliva beneath the skin that may arise when the parotid salivary gland's severed end continues to produce saliva. It will seem like a fluid-filled bulge at the surgery site that will get bigger with eating. Sialoceles usually resolve on their own; however, they may need further operations such as aspiration or drainage.

Ear numbness: When the greater auricular nerve or any of its branches is severed during the treatment, it may cause decreased feeling in the ear as well as the skin of the neck and face. Many parotidectomy surgeries need this. If the larger auricular nerve was sacrificed during surgery, the region of numbness will reduce with time, but the lobule of the ear will remain numb indefinitely.

Frey's syndrome (also known as "gustatory sweating") is characterized by perspiration on the side of the face when eating. When the parotid gland is removed, the nerve terminals that typically trigger saliva production and secretion may occasionally innervate sweat glands in the skin, causing perspiration rather than salivary release when engaged during eating. The degree of this condition might range from hardly detectable to quite severe. Treatment possibilities include applying antiperspirant to the face skin, injecting botulinum toxin (Botox) in that area of the skin, surgery to build a barrier beneath the skin, or middle ear surgery to sever the nerve that causes all of these difficulties close to its source. The insertion of a barrier ahead of time during the first operation may assist to avert Frey's syndrome. When this is done, the drain will most likely be left in place for a longer amount of time, maybe up to a week following surgery.

Facial nerve injury: During parotid surgery, every branch of the facial nerve has the potential to be damaged. This is usually only transient as a result of nerve dissection during surgery. However, if one or more of the facial nerve branches is accidentally severed or purposely sacrificed during surgery, it may be irreversible.