Parotid surgery

Parotid tumor

The parotid gland is the salivary gland located behind the ascending ramus of the mandible. It is the site of the most common tumors, notably pleomorphic adenomas, also known as mixed tumors.

Their treatment is exclusively surgicalThis involves removal of the entire parotid salivary gland, or parotidectomy, after dissection of the facial nerve (responsible for facial mobility) which runs inside the gland.

Experience of this type of surgery and the right equipment (computerized facial nerve control or nerve monitoring) minimize the risks of surgery.

The tumor is most often revealed by a mass or "lump" palpated by the patient or his doctor, and is rarely painful or associated with lymph nodes or facial paralysis.

the mass may be large and located behind the mandible

Ultrasound is the non-invasive test that confirms the diagnosis, but magnetic resonance imaging (MRI) can also be used.magnetic resonance imaging (MRI) is the gold standard for tumor visualization, and can also detect multiple lesions. With certain sequences, a diagnostic orientation on the nature can be strongly suspected. In claustrophobic patients, MRI can be replaced by a CT scan.

A cytopunction may be performed to analyze tumor cells and provide information on the nature of the mass, but rarely changes the therapeutic approach, which remains surgical.

The Parotidectomy procedure

This procedure involves removing the swelling and determining its nature. Some tumors can become infected or increase in size, making the operation much more dangerous in terms of preserving the facial nerve that runs through the gland. Other tumors may be malignant in nature or develop secondary cancer.

The procedure is usually performed under general anaesthetic.

The skin incision is best made using a facelift approach, to minimize scarring.

The facial nerve will be located and dissected with the aid of the neuro-detector to remove the tumor and surrounding glandular tissue. The surgical specimen is then sent for histological analysis during the operation, to identify the nature of the tumor.

The facial nerve and its branches are dissected for this procedure.

As a rule, a drain will be placed in the operated area.

Hospital stay is 24 to 48 hours. There is no post-operative pain.

minimal scarring with a facelift incision

Surgical risks

Post-operative hematoma may occur, but is rarely a cause for concern. You may experience some transient pain and difficulty chewing. You may also experience some neck pain, due to the position of your head during the operation.

A transient loss of sensitivity in the cheek and pinna is systematic.

Paralysis of the face is possible, with varying degrees of intensity depending on the surgical difficulties and the anatomical layout of the nerve. This is usually temporary and partial, lasting up to 8 weeks.

Definitive facial paralysis is exceptional. It is due to a particularly difficult operation (inflammatory or infected tumor, re-intervention) or to deliberate sacrifice of the nerve for a cancerous tumor that has invaded the nerve.

The formation of small subcutaneous cysts is exceptional after removal of the gland. Similarly, it is very rare for a little saliva to leak through the scar. These problems regress rapidly with careful treatment.

In the years following surgery, you may notice "sweating" in the surgical area during feeding. This phenomenon is known as Frey's syndrome.