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