Parotid Surgery

The parotid gland is a primarily serous salivary gland that is located high in the neck in the preauricular area extending towards the cheek.

Lumps (tumours) in the parotid gland are common and are seen in all age groups. They are the result of an abnormal growth of cells within the gland, though the exact reasons for this are not clear. The vast majority (approximately 80%) of these tumours are not cancerous and are called benign tumours. Rarely, however, some tumours can be cancerous.

Other common causes of lumps in the gland include stones in the duct of the gland, which often block the flow of saliva. This blockage often gives rise to infections, which can sometimes be troublesome.

Symptoms of Parotid Tumors include

• Unexplained painless or painful growth of the parotid gland
• Lump in the cheek, neck, or mouth
• Sensation of fullness of the parotid gland
• Numbness or changes of sensation over parts of the face
• Sudden onset of facial or neck pain
• Twitching or weakness of the facial muscles
• Paralysis of the face
• Difficulty with speech

Investigations of Parotid Problems

During the initial consultation, a detailed history is taken and also an assessment of your problem. This is usually followed by an ultrasound scan, which is performed by an expert radiologist. During the ultrasound scan, a needle may be inserted into the lump to collect a sample of cells. These cells are then analysed under the microscope by the pathologist who will often determine the nature of the swelling. Rarely, other tests such as a plain X-ray, CT scan, MRI scan or a sialogram may be required. These will be discussed with you where necessary.

Treatment of Parotid Problem

First line treatment for all parotid tumors, both benign and malignant, is generally surgical removal of the gland. The main risk to the parotid surgery which is called parotidectomy is facial nerve paralysis. Due to the variety of sensitive structures overlying, surrounding, and coursing through the parotid gland, exquisite care and dexterity must be implemented by the treating parathyroid surgeon to preserve function and avoid unwanted complications. For example, the facial nerve is intimately integrated into the parotid gland. The facial nerve is responsible for motor control of the face and partially responsible for taste sensation. The treating surgeon must be experienced and familiar enough to successfully identify, separate, and preserve this crucial structure and all its branches.