Overview of Parotidectomy

A parotidectomy is the removal of part or all of one of your parotid glands, the biggest of your three pairs of salivary glands.

Your parotid glands are found in front of your ears.

The most common reason surgeons perform a parotidectomy is to treat a cancerous or noncancerous tumor in one of your parotid glands. It may also be performed to treat infections in these glands or salivary gland stones.

Read on to learn more about a parotidectomy, including what you can expect during surgery and what your recovery might look like.

Parotidectomy purpose

A parotidectomy is used to treat difficulties with one of your parotid glands. These are the largest of your salivatory glands .

The most common reason a parotidectomy is performed is to remove a tumor . About 75% to 80% of parotid gland tumors are noncancerous.

Parotidectomy is also performed to treat other conditions , such as:

• parotid inflammation caused by salivary gland stones or other conditions
• infections
• parotid gland abnormalities present from birth

Parotidectomy types

Parotidectomies are divided into two main types depending on which part of your gland is removed.

Superficial parotidectomy

A superficial parotidectomy, also called a partial parotidectomy, removes only the outer part of the parotid gland that has a tumor in it. It has a lower risk of damage to your facial nerve than a total parotidectomy. Your facial nerve runs through your parotid gland.

Total parotidectomy

A total parotidectomy involves removing all of one of your parotid glands. It’s often used to treat:

• tumors found deep in your parotid gland
• aggressive cancer
• vascular malformations
• large tumors

Radical parotidectomy

A radical parotidectomy involves removing your entire parotid gland as well as your facial nerve. It may be used if a cancerous tumor involves your nerve or if you have facial paralysis before surgery. It’s often combined with nerve grafting or procedures that restore movement, function, and symmetry to your face.

Parotidectomy side effects and risks

Like all surgical procedures, a parotidectomy comes with risks. The following are the most common risks:

• facial bruising
• facial paralysis
• collection of fluid under your skin ( seroma )
• infection
• facial swelling and sweating while eating ( Frey syndrome )
• first-bite syndrome, which includes painful spasms during the first bite of food that decrease after
• inflammation of the masseter muscles around your jaw ( trismus )
• salivary fistula, which is an atypical connection of the salivary duct with the skin where saliva is excreted through a wound

How effective is parotidectomy?

Parotidectomy can be effective at treating parotid tumors and other difficulties with these glands. The tumor recurrence rate after parotidectomy is around 2% .

In a 2023 review of studies , researchers compared the results and complication rates between superficial parotidectomy and a less extensive procedure called partial superficial parotidectomy for treating noncancerous tumors.

Compared with a superficial parotidectomy, partial superficial parotidectomy was associated with lower complication rates, shorter operational times, and comparable results.

Parotidectomy steps

A parotidectomy can be performed by a surgeon called an otolaryngologist who specializes in head and neck conditions. Here’s a general idea of what you can expect before, during, and after your procedure.

Before the procedure

You’ll receive a general anesthetic to put you into a sleep-like state of nonfeeling during your procedure. The anesthetic will be administered through an intravenous (IV) line into your hand or wrist or through a mask that covers your face.

During the procedure

The procedure that the surgeon follows can vary. Here’s a general idea of what you can expect. The surgeon will:

1. Make a cut 2 to 3 inches long in front of your ear. The cut is extended downward into your neck and sometimes up to your temple. You may have a small amount of hair removed.
2. Locate your facial nerve to make sure it isn’t damaged during the procedure.
3. Work around your nerve to remove all or part of your parotid gland.
4. Remove the gland and seal your wounds with stitches.

After the procedure

You may have a small tube inserted into your wound to help drain blood that may pool around your incision. The drain will usually be removed 2 to 3 days after your surgery. Stitches are often removed about a week after your procedure.

Preparing for parotidectomy

A doctor can give you specific instructions on how to recover from a parotidectomy. They may tell you to stop taking blood-thinning medications before your surgery. They’ll also tell you how far in advance of your procedure you’ll need to stop eating and drinking.

Recovering from parotidectomy

Many people have facial swelling or weakness of their facial muscles after their surgery. Generally, according to a study from 2014 , symptoms improve after a few weeks, and you’ll likely need to spend at least one to two nights in the hospital. Many people need to take at least a week off of work.

Exercises administered by a speech or language therapist may help speed up the recovery of muscles in your face. According to a study from 2014 , about 1% of people have permanent weakness in their face.

Are there any alternatives to parotidectomy?

You may also receive another type of surgery called an extracapsular dissection or limited parotidectomy. These procedures are now routinely used to treat small noncancerous tumors.

How much does parotidectomy cost?

The cost of your procedure depends on factors, such as:

• your insurance coverage
• how long you need to stay in the hospital
• where you live

For reference, the nonprofit FairHealth estimates that 80% of procedures in Frankfort, Kentucky, cost less than $3,600 for the medical procedure without insurance coverage. Additional costs can include:

• $13,534 for ambulatory surgical center costs
• $1,900 for anesthetics
• $29,111 for hospital outpatient facility costs

Frequently asked questions about parotidectomy

Here are some frequently asked questions people have about parotidectomies.

Is a parotidectomy a major surgery?

A parotidectomy is a major surgery that takes an average of about 3 to 4 hours . You’ll require a general anesthetic to put you into a sleep-like state of nonfeeling during your procedure.

What is the most common complication after parotidectomy?

Your facial nerve runs through your parotid gland. This nerve can become damaged during surgery, which can lead to weakened movements of the muscles on one side of your face. This weakness usually gets better over time.

How long does it take to recover from a parotidectomy?

Most people need to take at least a week off of work after their procedure. You may need to take longer off if you have a strenuous job.

Takeaway

A parotidectomy is a procedure to remove one of your parotid glands. These glands are the largest pair of salivary glands. The most common reason people need a parotidectomy is to treat a tumor.

Many people have facial weakness or bruising after their procedure. A small number of people may have permanent facial weakness due to damage to the facial nerve. Following your surgical team’s pre- and postsurgery instructions gives you the best chance of minimizing your chances of developing serious risks.