Parotidectomy

The parotid gland is the largest of the salivary glands. There are two parotid glands, one on each side of the face, just below and to the front of the ear. Salivary glands distributed throughout the neck and oral cavity provide saliva to aid in digestion. The main reason for a parotidectomy is to remove abnormal growths that occur in the parotid gland. The growths may be benign or malignant. Evaluation before surgery will include a complete physical exam and medical history. A few diagnostic tests that may be performed include: CT scan, MRI (magnetic resonance imaging), or a fine-needle aspiration biopsy.

Risks

As with any surgical procedure, there are some risks in a parotidectomy. The risks and complications include:

• Bleeding
• Infection
• Skin breakdown (usually a result of an infection)
• Nerve Injury
• Complications due to anesthesia
• Facial nerve paralysis
• Recurrence of the cancer
• Hematoma

Before the Procedure

1. Nothing to eat or drink after midnight the evening before the procedure. This includes all food, liquids, water, candy, mints or chewing gum. You may brush your teeth. You will not be able to undergo the surgery if you do not follow these instructions.
2. Please notify us of any medications and dosage (including insulin) or allergies you may have. You will be informed of which medications you can take on the day of surgery with a sip of water.
3. A week before the surgery, please avoid aspirin, aspirin-containing products, ibuprofen (Advil, Motrin, Aleve) or Vitamin E. Please notify our office if you are on any medications that affect bleeding, such as coumadin or warfarin. Please call our office if you have any concerns about any medications. (585-342-2080)
4. Remove all make-up, jewelry, nail polish, and artificial nails before surgery.
5. Do not bring valuables to the hospital (cash, credit cards, watches, jewelry, etc.).
6. You will be admitted to the hospital for observation after your procedure for one to two nights.

After the Surgery

After surgery, you can expect to have an incision and a drainage tube in place. The drain may be removed the next day. Removal of the drain has been described by most patients as discomfort rather than pain. There is a chance you will have some numbness, tingling, or decreased feeling around the surgical site, the side of your face, neck and lower ear on the affected side. This should be temporary, and improve on its own. Your doctor will tell you if surgery has any lasting effect on the facial nerve.

Activity: Sleep with your head elevated at least 30° when you lie down. An easy way to do this is by using two to three pillows for one week. Avoid any strenuous activity (bending, lifting, straining, or aerobic activity) for the first 2-3 weeks, or as directed. No jogging, aerobics, swimming or lifting.

Diet: Avoid extremely hot liquids or foods. You can expect soreness when you chew, so you may want to east softer foods. Drink as much fluid as you can to prevent dehydration. Advance diet from liquids to soft diet as tolerated.

Wound Care: There will be a drain in place, as described above. The drain will be removed once drainage subsides. A dressing will be in place over the incision. Please keep the incision clean and dry. Check your incision for signs of infection. Signs of infection include: redness, tenderness, swelling, warmth at the site, any pus-like drainage.

Medications: You may have some pain. For pain relief, use your pain medication as directed and as needed. Please notify our office if the pain medicine does not relieve your pain. Take your antibiotic as directed. Do not take aspirin, ibuprofen, or other blood-thinning products until your doctor says you can.

Follow-Up: Our office will notify you of the date and time of your follow-up appointment with Dr. Oliver. It will be approximately two weeks after your surgery.

Please call our office at 585-342-2080 for any of the following:

1. Trouble breathing or swallowing
2. Coughing up blood or persistent bleeding
3. Fever above 101°F
4. Pain that is not relieved by medicine.
5. Redness, swelling, or drainage at your incision site
6. Increased swelling of your face or neck.

Any changes in facial movement that seem to be different and are not an improvement (e.g. facial droop on one side that wasn’t present after surgery or is worse than it was at first).