Free abdominal fat transfer fat grafts have been used after superficial parotidectomy to restore facial contour. The most common reasons for removal of all or part of this gland are a. The procedure is most typically performed due to neoplasms tumors, which are growths of rapidly and abnormally dividing cells. Links to pubmed are also available for selected references. The standard treatment for obstructive salivary gland stones is a total parotidectomy. In addition to being intimately involved with the bodys critical nerves and structures, the parotid glands are also responsible for a host of important functions, including protecting the teeth from decay, initiating digestion and moisturizing the mouth. The surgery involves the area around the facial nerve the nerve governing facial expressions. The third most frequent operation was total parotidectomy, accounting for 30 cases 14. Top 10 benefits of minimally invasive parotid surgery.
This approach leaves scarring and facial contour deformities. This elearning course provides a step by step approach, lessons on objectives, preoperative information and postoperative complications, procedural anatomy and a test. Full text full text is available as a scanned copy of the original print version. Parotidectomy procedure cpt days1 excision of parotid tumor or parotid gland. This incision heals well with minor scarring and provides safe access to identify the facial nerve and remove all tumor tissue. No patient was offered or underwent extracapsular dissection. To treat a parotid tumor, part or all of the gland is removed. Variations of parotidectomy indications and technique. A parotidectomy is a surgical procedure to remove the parotid gland. Typically, long facial incisions are used to gain access. This sheet explains the surgery and what to expect. This study examined whether current surgical techniques improved functional outcomes after surgery for benign parotid tumours. Next, the posterior edge of the parotid gland was identified, and this was dissected free from the cartilage of the ear. General anesthesia will keep you asleep and free from pain during surgery.
Importance facial reanimation procedures share the same surgical field as a parotidectomy and are most easily accomplished at the time of facial nerve sacrifice. Tumors that extend into the deep lobe may require total parotidectomy. This new resource picks up where other surgical references leave off, providing highly visual, stepbystep guidance on more than 100 advanced and complex procedures in both general and subspecialty areas. Next, the surgeon removes the front lobe of the parotid gland. Your parotid glands are found in your cheeks, over your jaw, and in front of your ears.
This involves resection of the entire parotid gland, usually with preservation of the facial nerve. Parotidectomy with facial nerve dissection see sample operative notes at bottom of protocol. Parotidectomy parotidectomy is done under general anesthesia through an incision that courses just in front of the ear and into the neck. Nursing teaching for parotidectomy iowa head and neck. The main reason for a parotidectomy is to remove abnormal growths that occur in the parotid gland. Dissection was then carried along the posterior edge of the incision identifying the greater auricular nerve. The use of diathermy scissors in parotid gland surgery oncology. Analysis of facial reanimation procedures performed. Total parotidectomy with preservation of facial nerve. For a total parotidectomy, the superficial gland is dissected free of all of the facial nerve branches to the extent feasible, and the branches are. The parotidectomy procedure is the modern patient choice for parotid tumor removal. However, there is a chance that the nerve may be adversely affected by the tumor itself or by the surgical procedure needed to remove the tumor. It helps produce and control the release of saliva.
Neoplasms can be benign noncancerous or malignant cancerous. Parotidectomy parotid gland tumor surgery memorial. The nerve is free in areolar tissue for 1 cm before it enters the gland. Wax et al compared scalpel and bipolar scissors in the elevation of radial forearm fasciocutaneous free flaps. The surgery is performed by making an sshaped incision along a crease in the front part of the ear. Pdf the patient and may help in deciding the extent of surgery. Many of these are tumors that have spread from other areas of the body, entering the. It is important to confirm that the patient has regained full motor function as determined by twitch monitoring before attempting to dissect out the. Get a printable copy pdf file of the complete article 502k, or click on a page image below to browse page by page. Atlas of advanced operative surgery 1st edition pdf. Parotidectomy inpatient care what you need to know. Definition parotidectomy is the removal of the parotid gland, a salivary gland near the ear.
Accessory parotid gland tumors are located in difficult to reach areas of the face. It answers those questions most frequently asked by patients and has been compiled by experienced staff. Design prospective study of the surgical procedures of the diathermy scissors and a retrospective. After the surgery you will stay in the hospital up to a few days after your surgery. In particular with neck surgery there is a risk of.
Patientfamily will verbalize understanding of routine preoperative instructions. After major surgery, a graft is attempted to restore nerve function to facial muscles. Most received a partial superficial parotidectomy, which was performed in 5 cases 64. Learn about the parotidectomy, an online 3dvideobased course, accredited by the royal college of surgeons of england. This procedure is performed under a general anesthetic. Unlike the pleomorphic adenoma, it is more common in older white men and is the most likely to be bilateral in 10% of the cases. The transoral approach eliminates all facial incisions. Preserving the facial nerve is an important priority when removing a parotid gland tumor. No matter if you are a patient about to have surgery, a family member caregiver, a. A parotidectomy is surgery to remove part or all of your parotid gland. Postoperative infection is uncommon, and it is reported to occur in less than 3% of patients. Both procedures will be done at the same time and will involve two different entry points cuts in order to gain access to. Risks facial nerve paralysis after minor surgery should be minimal. Baptist downtown southside baptist south possible risks and complications.
This gland makes saliva, which enters the mouth through a tube duct near the back teeth. Heres what you can expect for a parotidectomy recovery time should you decide to go ahead with this procedure. The procedure typically takes from two to five hours to complete, depending on the extent of surgery and the skill of the surgeon. Partial superficial, superficial, and total parotidectomy. Parotidectomy is performed with an incision in front and below the ear. Parotidectomy is the removal of the parotid gland, a salivary gland near the ear.
If a tumor forms in the parotid gland, it can press on the facial nerve, causing discomfort and pain. As with any surgical procedure, there is a risk of bleeding, infection, scarring, and unforeseen complications. Although the incisional parotid biopsy is the diagnostic procedure of choice for systemic disease involving the parotid, the superficial parotidectomy remains the minimal biopsy of choice for a mass suspected to be a neoplasm in the parotid. The facial nerve is central to parotid surgery for both surgeon and patient. The mass itself can be found anywhere within the parotid gland. You will be given pain medicine and possibly antibiotics. The majority of parotid gland tumors are benign, however 20% of parotid tumors are found to be malignant. Patients may be quite sedated for several hours after surgery and may remain sleepy for much of the day. Superficial parotidectomy was undertaken in 43 cases 20. There are two parotid glands, one on each side of the face, just below and to the front of the ear. Free abdominal fat transfer for reconstruction of the.
Suite 504 culver city, ca 90232 telephone 310 2044111 fax 310 2044474. Lateral parotidectomy medical transcription sample report. A cosmetic incision is made in front of the ear on the effected side and sweeps behind the ear and down onto the neck for a short distance. To allow adequate monitoring of the facial nerve, paralytics should not be used beyond the induction of anesthesia. Salivary glands distributed throughout the neck and oral cavity provide saliva to aid in digestion. Warthins tumor benign papillary cystadenoma lymphomatosum is the second most common benign tumor of the parotid gland. In particular with neck surgery there is a risk of damage to multiple nerves in the head and neck area. Early reanimation would also reduce the duration of paralysis and may lead to better functional outcomes. The incision extends beneath the earlobe and moves forward to the upper neck. Parotidectomy with facial nerve dissection iowa head and neck. The treatment of parotid gland conditions is complex and extremely delicate. The parotidectomy procedure typically is carried out under general anesthesia. This nerve was dissected free and rotated posteriorly out of the field.
The facial nerve is typically identified and protected during a parotidectomy. The incision is usually closed with nylon sutures that are removed. The procedure is most typically performed due to benign or malignant tumors. Introduction a parotidectomy is the surgical excision removal of the parotid gland, the major and largest of the salivary glands. Parotidectomy is typically performed with the patient under general anesthesia. Parotidectomy is considered a clean surgical procedure. Near total parotidectomy with facial nerve dissection was documented for educational purposes.
The parotid gland is a primarily serous salivary gland that is located. Infection is avoided by adherence to sterile surgical technique. This is a teaching video for residents in head and neck surgery. Advance your surgical expertise with atlas of advanced operative surgery. A number of tumors can develop in the parotid gland. Since your surgeon performed a superficial parotidectomy, you will have to report the procedure with either 42410 or 42415 as this was not a total removal of the parotid gland.
Pdf malignant tumours of the parotid gland represent a group of relatively rare lesions. Parotidectomy discharge care what you need to know. Conservation of salivary secretion and facial nerve function in partial. After your procedure is completed, you will waken in a recovery area with a formal dressing in place that often wraps around your head. Patients who need a parotid tumor removed may have many questions regarding facial surgery. Parotidectomy is the removal of the parotid gland, located below the ear. The operation is performed under general anaesthetic and lasts four to six hours. A parotidectomy is the surgical excision removal of the parotid gland, the major and largest of the salivary glands.
Major complications include facial nerve paresis or paralysis, and minor complications include salivary fistula, auriculotemporal syndrome gustatory sweating or frey syndrome, great auricular nerve anesthesia, and hemorrhage. Parotidectomy definition of parotidectomy by medical. Table 4 complications of parotid surgery according to type of operation. Superficial parotidectomy deep lobe parotidectomy surgeons will spend their entire career trying to learn when it is safe or necessary to do more or less than a superficial parotidectomy 6 superficial parotidectomy indications neoplasm risk of metastasis recurrent infectionabscess surgical exposure deep lobe parapharynx. How is a neck dissection and superficial parotidectomy performed. The most common reason to remove this gland is due to an abnormal mass contained within. Serious complications from parotidectomy are very rare. Parotidectomy for more patient education information. Purpose the main purpose of parotidectomy is to remove cancerous tumors in the parotid gland. Parotidectomy for a benign tumour is demonstrated in four steps.
The skin overlying the parotid gland is then elevated to expose the entire gland. It is usually a welltolerated procedure with only mild to moderate pain afterwards. Parotid surgery post operative instructions nurse line 8. They release saliva into your mouth through the parotid duct. During the procedure, an incision is made in front of the ear, extending to beneath the ear lobe and down the side of the neck. You will next have to see if the facial nerve was dissected and preserved during the procedure. Sialendoscopy allows these obstructive stones, which are causing the gland to be swollen, to be removed nonsurgically, avoiding the standard risk associated with parotidectomy such as facial nerve paralysis and facial deformity. Parotidectomy is a surgical operation to remove a large salivary gland the parotid gland located in front and just below the ear. Surgery to remove a parotid gland tumor parotidectomy. Parotidectomy, a surgical procedure to treat benign and malignant diseases of the parotid gland, has welldocumented postoperative complications 1,2.
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