Have you noticed a small lump or swelling on the side of your cheek, right near your ear? Or perhaps you feel a sharp pain in that area whenever you sit down to eat a meal? These signs often point to an issue with your parotid gland, which is the main gland responsible for making spit in your mouth.
When something goes wrong with this gland, doctors may recommend a specialized operation called a parotidectomy. Hearing about this surgery for the first time can feel scary and overwhelming. However, understanding the procedure step by step can help put your mind at ease and prepare you for what lies ahead.
Key Takeaways
- A parotidectomy removes part or all of your parotid salivary gland to treat non-cancerous growths, cancerous tumors, or painful salivary stones.
- Surgeons take special care to protect your facial nerve, which controls your facial expressions like smiling and blinking.
- Temporary numbness or facial weakness can occur after surgery, but most side effects improve over time.
- Following your doctor's instructions before and after the operation ensures a safe and smooth recovery.
- Contact your doctor right away if you experience severe pain, excessive swelling, or signs of infection around your wound.
What Is a Parotidectomy?
A parotidectomy is an operation to remove all or part of your parotid gland. You have two parotid glands located just in front of your ears on either side of your face. Their main job is to make saliva, which moistens your mouth and helps you chew and swallow food easily.
Doctors usually recommend removing this gland for two primary reasons:
- Tumors and Growths: Growths can sometimes develop inside the gland. The vast majority of these growths are benign, meaning they are non-cancerous. However, a small percentage can be cancerous. Doctors perform this surgery to find out the exact type of growth and remove it safely.
- Salivary Stones: Sometimes, tiny hard stones block the tubes that carry spit from the gland into your mouth. This blockage causes the gland to swell, triggers sharp pain while eating, and leads to frequent infections. Surgery is often necessary when other treatments fail.
What Are the Main Types of This Surgery?
The specific type of surgery you need depends entirely on where your growth or problem is located. A very important nerve called the facial nerve runs right through your parotid gland. This nerve controls your facial movements, such as smiling, closing your eyes, and moving your mouth. Surgeons take great care to protect this nerve during the operation.
There are two main types of parotidectomy procedures:
| Surgery Type | Description |
|---|---|
| Superficial Parotidectomy | Surgeons remove only the portion of the gland located above the facial nerve. This approach is common when the growth sits in the outer part of the gland. |
| Total Parotidectomy | Surgeons remove the entire gland. This happens when the growth lies deep beneath the facial nerve or spreads throughout the entire gland structure. |
Doctors can also use these surgical techniques to remove stubborn salivary stones that block normal flow. Your surgeon will review your test results and recommend the best option for your health.
How Should You Prepare for Surgery?
Feeling nervous or overwhelmed before an operation is completely normal. However, knowing what to expect helps you manage your anxiety. Your surgical team will provide clear guidelines to follow before your procedure date:
- Stop Smoking: Smoking slows down wound healing and increases your risk of complications. Stopping smoking several weeks before your surgery greatly benefits your recovery.
- Review Your Medicines: Tell your doctor about every medicine you take, including blood thinners like aspirin, vitamins, and herbal supplements. Your doctor will instruct you on which ones to stop taking before surgery.
- Follow Fasting Rules: Ask your care team exactly how many hours before surgery you must stop eating and drinking.
- Confirm Hospital Stay Details: Check whether you can go home on the same day or if you need to stay in the hospital for a day or two.
- Arrange Support at Home: Plan for a trusted family member or friend to drive you home after discharge and help you during your first day at home.
Bringing a family member or friend to your medical appointments is a great idea. While you talk with your doctor, your companion can take notes so you do not miss any important details.
Tests Before Surgery
If you have a lump, your doctor may order specific tests before surgery to understand its exact nature:
- Fine-Needle Aspiration (FNA): A doctor uses a very fine needle to take a small cell sample from your lump. Pathologists then examine this sample to check for cancer cells.
- CT Scan or MRI Scan: Doctors order these imaging scans if the growth sits very close to your facial nerve. This helps your surgeon plan the safest way to remove the growth without harming the nerve.
How Is the Surgery Performed?
Inside the operating room, an anesthesiologist will give you medicine through an intravenous line in your arm to put you into a deep, painless sleep. You will feel no pain while the operation takes place. Your surgeon then follows these key steps:
1. Making the Cut: The surgeon creates an incision starting in front of your ear, running down past your earlobe, and following a natural skin crease along your upper neck. This placement ensures the resulting scar remains hidden over time.
2. Exposing the Gland: The surgeon gently lifts the skin to reveal your parotid gland. They may use a specialized monitoring device during surgery to check the health and activity of your facial nerve continuously.
3. Removing the Gland: The surgeon carefully removes part or all of the gland. If tests show the condition has spread to nearby lymph nodes, the surgeon removes those nodes at the same time.
4. Closing the Incision: Once the gland tissue is removed, the surgeon closes the skin incision neatly using stitches or surgical staples.
5. Inserting a Drain: Finally, the surgeon places a thin, flexible tube called a drain near the surgical site to collect any extra blood or fluid.
This entire surgical procedure usually takes between two to four hours to complete.
What Are the Benefits and Possible Risks?
Like any medical procedure, a parotidectomy offers important benefits along with potential risks and side effects.
Main Benefits of Surgery
For benign growths, this surgery cures the condition completely. It also offers a reliable cure for stubborn salivary stones and recurrent infections. If doctors find a cancerous growth, removing it early gives you the best chance of stopping the disease from spreading. However, note that some cancerous growths carry a risk of returning in the future.
Possible Complications and Risks
Because this procedure is complex and sits close to delicate facial nerves, certain complications can happen. Fortunately, most of these issues are temporary.
| Complication | Simple Explanation |
|---|---|
| Numbness of Face, Ear, or Jaw | You may feel numbness around your ear and cheek after surgery. This feeling usually fades gradually within three to four months, or sometimes up to a year. |
| Facial Weakness | Stretching the facial nerve during surgery can cause temporary weakness. One side of your face might droop slightly, your smile may feel uneven, or closing your eye tightly could prove difficult. This condition improves and resolves fully within weeks or months. |
| Frey's Syndrome | This unusual condition can develop several months after surgery. When you eat food, your cheek on the operated side may sweat slightly. Treatments are available if this bothers you. |
| First Bite Syndrome | Taking the very first bite of any meal can trigger a sharp pain in the surgical area. This brief pain occurs only on the first bite and disappears during the rest of the meal. |
In addition, general surgery risks include:
- Allergic reactions to pain medicines.
- Fluid buildup around your wound.
- Excessive bleeding.
- Blood collection under the skin called a hematoma.
Common Side Effects
You can expect to experience these normal side effects after your operation:
- Pain and Swelling: Mild to moderate pain and swelling around the surgical site will last for a week or two.
- Difficulty Chewing: Jaw stiffness can make eating uncomfortable at first. This improves within two to four weeks.
What Happens After Surgery?
When you wake up, you will be in the recovery room. Nurses will monitor your pulse, blood pressure, and vital signs closely, and provide medicine to manage your pain. To check that your facial nerve is working properly, they may ask you to smile, close your eyes tightly, or wrinkle your forehead.
Before you leave the hospital, your care team will teach you how to care for your wound and drain tube. They will also schedule your follow-up appointments. A typical follow-up schedule looks like this:
- 1 to 2 days after surgery: Remove the surgical drain.
- 5 to 7 days after surgery: Remove non-dissolvable stitches if applicable.
- 4 to 6 weeks after surgery: Follow up with your surgeon to check your healing progress.
How Long Does Recovery Take?
Full recovery takes several weeks. Most people return to their normal daily routines within about two weeks. However, complete recovery of facial sensations or minor muscle strength can take several months or up to a year.
If It Is Cancer, What Is the Long-Term Care?
Cancerous parotid gland tumors can sometimes return. For this reason, your doctor will keep you under regular medical observation for several years following your surgery. Attending frequent follow-up exams and waiting for test results can feel emotionally exhausting. Sharing your worries openly with your doctor and family members provides vital emotional support during this time.
When to Call the Doctor Right away
Contact your doctor or seek emergency medical care (call 911 in the US/Canada, 999 in the UK, or visit your nearest Emergency Department) if you experience any of these warning signs:
- Severe pain that does not improve even after taking prescribed pain medicine.
- Numbness or facial weakness that suddenly gets worse.
- Pus, cloudy fluid, or heavy bleeding coming from your incision wound.
- Skin around the wound that feels very hot to the touch or grows increasingly painful.
- A foul odor coming from your surgical incision.
These symptoms may signal an infection or complication that requires urgent medical attention.
A Note from Dr. Priya Sammani
Facing any surgery on your face or neck can feel daunting. Please remember that parotid gland surgeries are performed safely every day by skilled surgical teams. Asking questions, following your doctor's instructions closely, and giving your body time to rest will set you up for a smooth and successful recovery.
Sources & References
- Mayo Clinic. (2025). Parotidectomy: Overview, Procedure, and Recovery. Available online: Mayo Clinic Health Information.
- NHS UK. (2024). Parotid Gland Surgery and Salivary Gland Tumors. Available online: National Health Service.
- Cleveland Clinic. (2023). Parotidectomy: What to Expect Before, During, and After Surgery. Available online: Cleveland Clinic Medical Library.
- National Institutes of Health (NIH). (2022). Facial Nerve Management and Outcomes in Parotid Surgery. PubMed Central (PMC).
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