Is there a lump on the side of your cheek? Let's talk about Parotidectomy!

Have you ever noticed a small lump in front of your ear, on your cheek? Sometimes it may be painless, but sometimes it may hurt when you eat. It's normal to feel a little scared when you see something like this. The cause of this lump may be a tumor or stone in one of the main salivary glands in our mouth. Today we are going to talk about a special surgery that is performed in such a situation. Don't worry, let's explain everything in simple terms.

What is Parotidectomy?

Simply put, a Parotidectomy is a surgical procedure that removes part or all of the salivary glands in front of your ears called the Parotid Gland. These are the largest salivary glands in our body. When we eat, these glands help produce saliva to make it easier to swallow.

So why do you need to remove this gland? There are two main reasons:

1. Tumors: If a tumor develops in this gland, it can be cancerous or benign.

2. Salivary Stones: Sometimes, "stones" can form in this gland, blocking the ducts that carry saliva. This can cause saliva to accumulate and cause the gland to swell and become painful.

It is in situations like this that the doctors decide to perform this surgery.

Are there main types of this surgery?

Yes, the way this surgery is performed depends on the location of the tumor or problem. A very important nerve that controls our facial expressions, such as when we smile and close our eyes, runs through your parotid gland. We call it the facial nerve . There are two parts of the gland above and below this nerve. Accordingly, the surgery is divided into two types.

1. Superficial Parotidectomy: This involves removing a tumor from the gland above the facial nerve. This type of surgery is most often performed.

2. Total Parotidectomy: In this, if there is a tumor in the deep part under the facial nerve, or if the tumor has spread to both parts, the entire gland is removed.

The doctor will examine you and, if necessary, perform scans to determine exactly what surgery you need to have.

How do you prepare for surgery?

Since this is a surgical procedure, there are a few things you need to prepare for before it happens. Your surgeon (an otolaryngologist - an ear, nose, and throat doctor) will give you specific instructions on this.

These are the things you usually have to do:

• If you smoke, you should stop before surgery. Smoking delays wound healing.
• Tell your doctor about any medications (e.g., for diabetes, blood pressure) or vitamins you are taking. You may be asked to stop taking some medications (especially blood thinners) a few days before surgery.
• Find out exactly when you should stop eating and drinking before surgery.
• Ask if you will have to stay in the hospital after the surgery, or if you can go home the same day.
• Arrange for someone to accompany you home and someone to take care of you for the first 24 hours or days after you return home.

Preoperative tests

If there is a tumor, the doctor may perform several tests before surgery:

• Fine-needle Aspiration (FNA): A very small piece of tissue is taken from the tumor using a fine needle and tested for cancer cells.
• CT scan or MRI scan: If the tumor is very close to the important facial nerve, these scans can help the surgeon, like a map, to be careful not to damage that nerve during surgery.

What happens during the surgery?

You won't feel anything about this, because the surgery will be performed under general anesthesia and you will be sound asleep.

The surgeon follows these steps:

1. Making an incision: An incision is made starting in front of your ear, going below the earlobe, and following a natural crease at the top of your neck. This is done so that the incision is not easily visible later.

2. Exposing the gland: The skin is pulled back to expose the parotid gland. At this time, a facial nerve monitoring device may be used to monitor for damage to the facial nerve.

3. Removal of the gland: The necessary part of the gland or the entire gland is carefully removed. If tests confirm that it is cancerous and it is found to have spread to nearby lymph nodes, those lymph nodes are also removed at the same time.

4. Stitching the incision: Then the incision is sewn back together nicely.

5. Inserting a drain: A small tube (surgical drain) is inserted to stop blood or other fluids from accumulating inside the wound and to drain them out. This is removed in a day or two.

This entire surgery usually takes about two to four hours.

What are the benefits and risks of this surgery?

Like any surgery, this one has both benefits and risks.

The main advantage is that it can cure the disease in the parotid gland. If it is a normal tumor, it will be completely cured after surgery. If it is a cancerous tumor, it can be removed before it spreads to other parts of the body and can save lives. It is also an effective treatment for severe pain and infections caused by salivary stones.

However, because this is a somewhat complex surgery, there are some risks and side effects that can occur. Most of these are temporary.

What happens after the surgery?

When you wake up from anesthesia, you will be in a recovery room. The nursing staff will constantly check your pulse and blood pressure. They will give you pain medication. They may ask you to smile and close your eyes tightly to check that your facial nerves are working properly.

Before you go home, you will be instructed on how to care for your wound, how to care for the drain (if any), and when you will need to return to have the stitches removed and the drain removed.

How long does it take to recover?

You can usually resume your normal activities after about two weeks. However, the aforementioned numbness and facial weakness can take several months or even a year to fully recover. It's important to be patient.

If a cancerous tumor is removed, you will need to see your doctor regularly for a long time (perhaps up to 20 years) to see if it comes back.

When do you need to see your doctor?

When you go home after surgery, you should call your doctor immediately if you have any of the following symptoms:

• If you have severe pain that does not subside even after taking medication.
• If you feel like your facial numbness or weakness is increasing.
• If the wound is oozing pus, fluid, or blood.
• If the area around the wound is red, feels hot to the touch, or hurts when touched.
• If there is a bad smell coming from the wound.

These symptoms may be signs of an infection, so it is important to seek treatment quickly.

Parotidectomy, salivary gland, cheek tumor, facial nerve, surgery