Parotidectomy is the surgical removal of the parotid gland, a salivary gland located just in front of the ears on either side of the face. The procedure is most often performed due to the presence of benign or cancerous tumors within the gland. Due to the location of the parotid glands, this surgery is very demanding and is typically performed by a head and neck surgeon, like Dr. Furze, who is highly experienced in carrying out parotidectomies.
Humans have two parotid glands, which are located on either side of the mouth in front of the ears. The largest of the salivary glands, the parotid glands release saliva into the mouth to support eating and digestive processes. The glands are wedge-like structures that stretch from the front of the ears, across the cheekbones, and to the angular edge of the lower jawbone. Several structures run through the glands, including the facial nerve, large veins, and arteries. Due to the presence of these important structures, extreme care must be exercised while performing this surgery.
Dr. Furze performs this surgery at HOAG Memorial Hospital in Newport Beach. The patient will be under general anesthesia during the surgery and monitored by an anesthesiologist the entire time. First, Dr. Furze carefully makes a long incision, starting near the top of the patient’s ear and ending below the jawbone close to the center of the neck. This long incision provides him with complete access to the parotid gland and a clear view of the important structures within and around the gland. Next he carefully moves the skin away to expose the parotid gland. Dr. Furze identifies the facial nerve branches and ensures they are protected before proceeding. The identification and protection of the facial nerve is generally the most time-consuming and laborious part of the surgery, lasting anywhere from 1 – 3 hours. Finally, Dr. Furze carefully excises the parotid gland itself. After the gland is removed, he meticulously stitches the surgical wound closed.
A primary goal when performing parotidectomy is to avoid damaging the nerves in and around the parotid. When the facial nerve is fully protected during the surgery, the risk of facial paralysis is very low. Some patients, however, do experience temporary facial paralysis after the procedure even when the nerve has been handled correctly. Another complication of parotidectomy is the occurrence of Frey’s Syndrome. This happens when the facial skin over the parotid gland fuses with sweat glands below, causing the area to sweat whenever the individual eats. To minimize the risk of Frey’s Syndrome, Dr. Furze tries to make the skin flap over the area as thick as possible.
All patients will experience some loss of sensation in the skin around the ear where the parotid gland was removed. This occurs because the sensory nerves near the ear are cut during surgery.
Ear numbness typically improves within 9-12 months following surgery. In addition to these unique complications, patients undergoing parotidectomy may experience surgical complications, such as adverse reaction to anesthesia, bleeding, hematoma, and infection. These complications can be minimized by following all of Dr. Furze’s pre- and post-surgical instructions and contacting our office at the first sign of a problem.