Suite 2, Level 4/24-40 Bigge St, Liverpool NSW 2170
(02) 9810 9839
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Sydney Southwest Private Hospital

Suite 2, Level 4/24-40 Bigge St, Liverpool 2170
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Parotidectomy

Surgery performed by Dr Navin Niles Endocrine and Head & Neck Surgeon

What is the Parotid gland?

Parotid glands are two of the largest salivary glands situated in front of and beneath each ear. The Parotid glands secrete saliva into the mouth which assists with chewing.

The parotid glands produce a type of saliva that is serous, this means it’s watery and thin. The enzyme found in saliva, amylase, initiates the digestive process by breaking down starches in the food. Saliva is also a lubricant to guide the food through the digestive tract.

When we are not eating, the parotid glands each contribute ten percent of saliva in the mouth. However, when stimulated by eating, each parotid gland creates twenty-five percent of all saliva.

The mouth affects the health and functionality of other parts of our bodies, making the parotid glands health vital. When the parotid or salivary glands don’t function properly, a variety of problems occur in other parts of the body.

What is a Parotidectomy?

To access the parotid gland, an incision will be made near the ear. Special care is taken to avoid damage to nearby structures, such as the facial nerve that runs through the parotid gland.

If the facial nerve must be cut to remove all of the tumours, surgeons can repair the nerve by using nerves from other areas of your body or processed nerve grafts from donors.

Operations used to remove parotid tumours include:

·     Superficial Parotidectomy – Removing part of the parotid gland. For most parotid tumours, the tumour and some of the healthy parotid gland tissue around it will be removed.

·     Total Parotidectomy – Removing all the parotid gland. This method is recommended for larger tumours and those that affect the deeper parts of the parotid gland.

However, if parotid cancer has grown into nearby bone and muscles, a more extensive operation may be necessary. Once all cancer and a small amount of the healthy tissue that surrounds it is removed, then the work begins to repair the area so you can continue to chew, swallow, speak, breathe and move your face. This may involve transferring skin, tissue, bone or nerves from other parts of your body to make repairs.

Why would you need to undergo Parotidectomy Surgery?

You might require parathyroid surgery when the following occurs:

·     Parotid Tumour – A parotid tumour that is benign can still grow and affect the surrounding tissues and the function of other organs.

·     Deep Lobe Parotid Tumours – This type of tumour needs to be removed surgically because it can threaten the surrounding tissues and possibly become cancerous.

·     Parotid Stones – Parotid stones occur when small calcium deposits form in the salivary gland.

·     Parotid Cysts – These are masses that occur in the parotid glands, and only occur in about 5% of all tumours in the salivary gland.

·     Parotitis – This can disrupt function in the parotid gland. Salivary gland blockage, auto-immune disease, diabetes, radiation in the head or neck, or viral infection may cause parotitis. Some common symptoms include facial swelling, pain in the area, and dry mouth.

Most people are not aware of whether their parotid gland is functioning correctly or not. There are several different disorders that can occur in the Parotid gland, which is why salivary gland health can be so important to your overall health.

Frequently Asked Questions

Please see below for answers to our FAQ’s. In addition to this, you will find a range of information sheets over at our Services page. If you require further assistance, then feel free to email us via the Contact page. 

The reasons for removing a nodule (lump) from the thyroid include – it causes symptoms including difficulty swallowing, it is cosmetically concerning, it is overactive, it is cancer. The aim of investigation of a thyroid nodule is to exclude these reasons and so to, if possible, avoid needing surgery.

Many people think a thyroid nodule is not part of the thyroid. In fact, the nodule is within the thyroid. Its removal usually requires the removal of half (hemithyroidectomy) or the whole thyroid gland (total thyroidectomy).

Not because of your surgery. Weight loss or gain is as a result of an imbalance between energy intake and expenditure. Ideally, thyroid hormone levels following surgery can be adjusted by administration of thyroid hormone to be within the normal range. In these circumstances, surgery or being on thyroxine replacement are not responsible for weight gain or loss.

The lymph nodes removed in neck dissection are in the order of 25% of the lymph nodes of the entire head and neck, which are only a fraction of the nodes in the entire body. Whilst it is possible that recovery from surgery and other treatment may render the patient less able to avoid some infections, this is more to do with general conditioning than the effect of lymph node removal.

No. The high level of calcium in the blood of a person with hyperparathyroidism is largely because the bones are being stripped of calcium. In the presence of high levels of parathyroid hormone (hyperparathyroidism), it is not possible for calcium to be laid down to strengthen bones.

It is fairly normal for even a perfectly healing wound on the neck to become darker over the first 6 months of healing before eventually fading. It is true however that it is most unusual for the scar to disappear, and that someone who has had surgery will always be able to see the scar.

As discussed on the parotid surgery page, the key to parotid surgery is the identification and preservation of the facial nerve. This nerve exists at the base of the skull about 4cm deep to the skin of the earlobe. Because the nerve is deep at this point, and this is the safest place to identify the nerve, the incision needs to be large enough to afford a good view. Once the nerve is found, the branches of the nerve need to be traced through the gland, past the tumour to allow for the safe removal of the tumour.

A/Prof Niles is a General Surgeon. Most General Surgeons contribute to the local community by taking part in an on-call roster at their local hospital to provide Emergency and Trauma Surgery cover. So, when A/Prof Niles is on-call at either the Northern Beaches, Sydney Adventist, Norwest or Liverpool Hospitals, he is required to care for those people who present to the Emergency Department with general surgical problems. This workload varies considerably, but can include appendicitis, cholecystitis, bowel obstruction and traumatic injuries to name just a few. Our aim is to provide excellent surgical care to any patients whose care we are entrusted.

Parotidectomy
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What to expect from Parotidectomy surgery?

Parotidectomy surgery is performed under general anaesthesia. Dr Navin Niles will make a small incision in front of the ear and down into the neck, to remove a part or all the parotid gland.

The incision is then closed with stitches. After the surgery, a temporary drain is placed behind the ear to drain fluids such as blood. The entire procedure takes about 3 to 4 hours to complete.

Recovery

After the surgery, you will be transferred to the recovery room, where you will need to spend the night. You will be able to eat and drink after the surgery, however, you will be instructed not to sleep on the operated side. The drain will be removed three to four days post-operatively.

You are advised to rest for 1- 2 weeks and avoid strenuous activities, your neck muscles may be stiff and occasionally a little sore. You should not drive until you can turn your head comfortably to have full vision of the inside lane and when reversing.

Heavy household work should be avoided for two weeks and heavy manual work, especially involving heavy lifting avoided for six weeks. Similarly, contact sport should be avoided for six weeks, but exercise to maintain fitness such as walking, running, swimming, and cycling can be started after a few days.

You must be careful when you’re showering, bathing, and shaving. Avoid applying cosmetics such as colognes or scented creams until the wound heals completely. Soreness or discomfort will reduce in 1-2 weeks. Avoid smoking to allow your body to heal.

Consult your doctor if you experience redness, swelling, bleeding or discharge, increased pain, or weakness in your facial muscles.