The parotid gland is one of the largest salivary glands in the human body. There are two of these glands in total, one on each side of the face, in front of and below the ears. The main function of these glands is to produce saliva, which they channel into the oral cavity through the excretory duct. From the parotid gland passes a motor nerve of the face, the facial nerve, which is responsible for carrying out several expressions. Cysts or tumors may sometimes develop in the area of ​​the gland, the presence of which may lead to the need of the parotid gland removal.

Benign tumors in the parotid gland: How they appear & what symptoms they cause

If cysts or tumors develop in the parotid gland, the patient may experience a noticeable swelling in the area of ​​the lower jaw, cheek, or in front of the ear. The majority of parotid tumors are benign. Such tumors are pleomorphic adenoma, which is the most common form, and Warthin’s tumor.

Benign tumors present with a perceptible lump, which moves during palpation. Their existence is painless and does not cause unpleasant symptoms. However, as there is a gradual increase in their size, causing distortions in the facial area and putting pressure on the facial nerve, which can lead to paralysis of part of the face, it is important to remove them.

Malignant parotid gland tumors: Types & Symptoms

In more rare cases, malignant tumors may appear in the parotid such as alveolar tumor and mucoepidermoid carcinoma, making the removal of the parotid gland imperative. In fact, if benign parotid tumors such as pleomorphic adenoma remain intact for a long time, they may develop malignancy. The occurrence of symptoms such as pain, a sudden increase in the size of the tumor or the appearance of paralysis of the facial nerve indicate the existence of cancer cells, i.e. malignancy. Generally, any swelling in the area is important to be thoroughly examined by fine needle biopsy in order to identify the nature of the tumor.

Parotidectomy – Parotid Gland Removal: Procedure

Parotidectomy is the surgery to remove the parotid gland. When a tumor is found in this area, removal of the tumor along with all or part of the parotid gland is indicated. After its removal, the tumor is subjected to a thorough histological examination, to exclude the existence of malignancy. This specific procedure presents a significant degree of difficulty as the personal nerve passes through the parotid gland. This particular nerve plays a dominant role in making facial movements, and any injury to it can lead to paralysis of the part of the face it innervates.

To protect the facial nerve and avoid unpleasant complications, it has been established to identify the course and branches of the nerve using neuromonitoring. This is carried out through a neurostimulator and diathermy with radio frequencies, where the nerve is identified by using electrodes, avoiding any injury. In rare cases where the tumor invades in the personal nerve, the surgeon may transect it.

The removal of the tumor is carried out by ENT Surgeon in Athens Dr. Olga Papadopoulou with careful movements, removing not only the tumor but also the part of the parotid gland that is close to it. If the tumor is malignant, along with its removal, lymph node cleansing is performed to avoid metastases. Finally, the incision is closed with plastic surgery sutures, for an excellent aesthetic result without scars, while also achieving faster healing.

Parotid gland removal: Post-Oparative course

After suturing the incision, a drain is placed which is removed after 1-2 days. The patient is discharged from the hospital on the same or next day, experiencing minimal post-operative pain. Analgesics are administered only at the request of the patient, while antibiotics are administered for preventive reasons. Sutures are removed after 1 week. It is recommended to avoid vigorous activities and heavy lifting for 2 weeks after surgery.