Parotidectomy

WHAT YOU SHOULD KNOW:

• A parotidectomy is surgery to remove a part, or all of one of your parotid glands. Your parotid glands are found in your cheeks, over your jaw and in front of your ears. Your parotid glands are one of the glands that release saliva (spit) into your mouth. You need saliva to help with chewing and swallowing. You may need a parotidectomy to remove a growth. The growth in your gland may be caused by an infection, inflammation (swelling), or a tumor (lump of tissue). In most cases a tumor growth is not cancer (benign). The growth may cause you to have pain and swelling in your face. The growth may cause facial numbness (loss of feeling), or decreased movement in parts of your face.
  
  
• Before having a parotidectomy, imaging tests may be done to help plan your surgery. The amount of your parotid gland that will be removed depends on where the growth is found. During surgery, your caregiver will check if your growth has spread to other areas, such as your neck. Having a parotidectomy may decrease your symptoms such as pain and numbness. Removing your growth may return your facial movements, such as smiling or blinking. If you have cancer, surgery may prevent it from spreading, or from coming back.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• If you have cancer, when your tumor is removed, cancer cells may spill out and form a new tumor. Your facial nerve and muscles may be damaged, and you may not be able to move parts of your face. Movement in your face may or may not get better over time. After surgery, you may get an infection, and have bruising and pain in your face and neck. You may have a dry mouth, trouble chewing, and you may sweat when you eat. You may have tingling, or lose feeling around your ear. You may have a large scar on your face, and your surgery may change the shape of your face. An abnormal opening may form near your wound and cause saliva to leak out. Even if your growth is removed, it may come back, and you may need another surgery.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• If you do not have a parotidectomy, your growth may become very large and painful. You may lose feeling in your face and have trouble chewing and swallowing. Your growth may cause changes in the shape of your face. If your growth is cancer, it may spread to other parts of your body. Certain parotid cancers may lead to death if they are not treated. Talk to your caregiver if you have questions or concerns about your surgery or treatment.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Before your surgery:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: A chest x-ray is a picture of your lungs and heart. You may need a chest x-ray the day of your surgery to check for growths in your lungs.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Pre-op care: You may be given medicine that makes you relaxed and sleepy right before your surgery. You will be taken on a stretcher to the room where your surgery will be done. You will need to lie on your back on the surgery table or bed.
  
  
• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

• Your caregiver may need to remove only a part of your parotid gland. If your growth is large, deep inside, or spreading, your caregiver may remove the entire parotid gland. If only a part will be removed, an incision (cut) is made above your ear and along your hairline. A larger cut above your ear and along your jaw is needed when your whole gland needs to be removed. Your caregiver will uncover and move your facial nerve aside so it is out of the way during surgery. Your caregiver may need to remove part of your facial nerve to reach your growth. If part of the nerve is removed, your caregiver may sew the cut ends together. Your caregiver also may need to rebuild the nerve using a nerve graft (a piece of another nerve). A special machine to monitor your facial nerve for damage may be used during your surgery.
  
  
• Your caregiver will then remove your growth by cutting out part or all of your parotid gland. Your caregiver may need to make another cut in your neck to remove any growth that has spread there. After the growth is removed, one or more drains may be placed in your cut. A drain is a thin tube used to remove fluid and blood from your surgery area. If you have a large facial cut, a muscle flap may be needed to close the cut. A muscle flap is a piece of your muscle taken from another body area. A muscle flap closes a larger cut in your face that cannot be closed with just stitches. Your cut will be closed with stitches or staples, and a bandage is placed over it.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. A caregiver may remove your bandage soon after surgery to check your wound (surgery site). When caregivers see that you are not having any problems, you will be taken to your hospital room. The drains in your wound area will be removed when the wound stops draining.

• Medicine:
  
  
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.