An en bloc deep lobe parotidectomy is defined as removal of all remaining parotid gland after superficial parotidectomy and includes the tissue deep to the fn. Parotidectomy procedure pdf the facial nerve is central to parotid surgery for both surgeon and patient. Injury to the facial nerve main trunk or branches during parotidectomy is quite common. Superficial parotidectomy with tumorfree margins is generally sufficient for treatment, but inadequate surgical resection leads to recurrence. Superficial parotidectomy superficial lobe parotidectomy describes removal of all or a portion of the parotid gland superficial to the facial nerve. In fact, in most cases we do not remove all of the parotid, just the lump with a good border of normal tissue around it.
Variations of parotidectomy indications and technique. You might notice bruising, swelling and hardness around your incision. Jan 30, 2019 a superficial or lateral parotidectomy involves removing all of the gland superficial to the facial nerve, whereas a partial superficial parotidectomy involves removing only the portion of the gland surrounding a tumor or mass. Superficial parotidectomy for areas that drain to the parotid basin. The parotid gland is the largest of the salivary glands. A parotidectomy is the surgical removal of the parotid gland. Current management of benign parotid tumorsthe role of. Please be advised that this video contains graphic footage of surgery. Although superficial parotidectomy is a highly standardized and safe procedure, limited parotidectomy for proven benign parotid salivary gland neoplasms is more likely to result in patients with minimal or no displeasing complications. Using a 15 blade, the skin incision was made and carried down to the level of the parotid fascia and platysma muscle. Parotidectomy surgery postoperative instructions keep the incision dry for 7 to 10 days while the steristrips are in place.
Thirty patients with a benign lesion of the parotid gland underwent a partial superficial parotidectomy via a modified facelift incision. A right partial superficial parotidectomy performed to remove a pleomorphic adenoma of the right parotid gland presenting as lump or mass. Pdf partial superficial parotidectomy via retroauricular. Size and location of tumors, operative time, occurrence of facial nerve paralysis and freys syndrome, and cosmetic outcomes were compared among rahi, facelift incision fli, modified blair incision mbi groups. Atlas of advanced operative surgery 1st edition pdf free. Parotidectomy is a surgical operation to remove a large salivary gland the parotid gland located in front and just below the ear. Cal technique of parotidectomy via a facelift incision is described and evaluated. A skilled head and neck surgeon is needed for both a deep and superficial lobe parotidectomy due to the close proximity of the facial nerve to the surgical site. This new resource picks up where other surgical references leave off, providing highly visual, stepbystep guidance on more than 100 advanced and complex procedures in both general and subspecialty areas.
A an incision was made along the postauricular sulcus and hairline without a. Parotidectomy discharge care what you need to know. This gland makes saliva, which enters the mouth through a tube duct near the back teeth. In particular with neck surgery there is a risk of damage to multiple nerves in the head and neck area. Deeper part of residual parotid tissues will continually secrete saliva and accumulates as sialocele. The most common reasons for removal of all or part of this gland are a mass in the gland, chronic infection of the gland, or obstruction of the saliva outflow from the gland causing chronic enlargement of the gland. Informed consent for parotidectomy introduction this information is given to you so that you can make an informed decision about having parotidectomy. Key operative learning points superficial parotidectomy allows resection of either part or all of the gland lateral to the facial nerve. Indeed, the incidence of transient dysfunction following parotidectomy is as high as 65%, 1 with permanent paralysis present in up to 5% of cases. Partial superficial parotidectomy with retrograde dissection. Oxford centre for head and neck oncology parotidectomy.
The majority of parotid gland tumors are benign, however 20% of parotid tumors are. Pdf superficial parotidectomy via facelift incision. Objective to evaluate the independent relationship of the shaw scalpel on the development of facial nerve injury in patients undergoing superficial parotidectomy. The parotid is a large salivary gland near the ear. Parotid surgery animation overview of minimally invasive. Superficial parotidectomy versus partial superficial. No statistically significant differences were found at any time of the study when comparing the frequency, magnitude and duration of paresis between eg and cg and among patients who had presented moderatesevere paresis. If the tumor is located on top of the facial nerve it is called a superficial lobe parotid tumor. Facelift type incisions were used in all patients, and temporoparietal fascia flaps were used to fill. Antibiotic ointment neosporin, polysporin, bacitracin purchased over the counter, should be put on the incision, twice a day, for the first 10 days, followed by vitamin e ointment twice a day and sunblock in am for the next 2 months.
Facial nerve dysfunction after total parotidectomy was found to be significantly higher p superficial parotidectomy 18. Feb 19, 2015 superficial parotidectomy superficial lobe parotidectomy describes removal of all or a portion of the parotid gland superficial to the facial nerve. Neoplasms can be benign noncancerous or malignant cancerous. Deep lobe parotidectomy plays an important role in the treatment of many parotid gland malignancies. Post operative instructions parotidectomy total or subtotal background information the salivary glands are responsible for a variety of disorders that may or may not require surgery. Reconstruction of facial nerve after radical parotidectomy. Facial flap was elevated forward, superficial to the parotid fascia using tenotomy scissors. The shaw scalpel and development of facial nerve paresis.
Superficial parotidectomy versus retrograde partial superficial parotidectomy in treating benign salivary gland tumor pleomorphic adenoma. The facial nerve has arbitrarily been set as the divider of the parotid, actually a single structure, into superficial lateral and deep lobes. Case 3 a 42 yearold woman underwent 3 years ago a superficial parotidectomy for a benign tumor of the parotid gland warthins tumor with immediate reconstruction by an autologous fat graft ml. Parotidectomy is the removal of the parotid gland, located below the ear. There are however other glands which make saliva a s well, one on each side under the jaw bone and hundreds of tiny o nes. This nerve controls the muscles on that side of the face. A parotidectomy is the surgical excision removal of the parotid gland, the major and largest of the salivary glands. These glands produce saliva, the first secretion involved in digestion. It helps produce and control the release of saliva. Feb 03, 2020 a parotidectomy is surgery to remove a part, or all of one of your parotid glands. Keywords parotid neoplasms, parotidectomy, superficial parotidectomy, partial superficial parotidectomy, facial nerve. Benign or low grade tumor of the superficial lobe of the parotid gland 2. Superficial parotidectomy the most common indications are.
Partial superficial parotidectomy via retroauricular. The stigma of a visually prominent facial scar following parotid surgery can be. Effectiveness of facial exercise therapy for facial nerve. For malignancies, surgical excision is the preferred treatment, with superficial or total parotidectomy depending.
Post operative instructions parotidectomy total or. Parotidectomy patient information sheet what is the parotid and what causes parotid lumps. Fortyeight percent of the surgical procedures were. Parotidectomy is considered a clean surgical procedure.
View the article pdf and any associated supplements and figures for a period of 48 hours. After partial or total parotidectomy, you will have a drain under the incision during which time you will hospitalized. However, any fn branches directly invaded by tumor were resected with negative margins using frozen. The procedure is performed by dr john chaplin head and neck endocrine and reconstructive surgeon, auckland, new zealand. Parotidectomy definition of parotidectomy by medical dictionary. The gland is removed to treat an infection that keeps returning or to take out a.
Second, although the parotid gland is not anatomically a truly bilobed structure, for purposes of surgical anatomy it may be considered to have a superficial and deep lobe with the branches of the facial nerve passing between these two structures. Anesthesia for parotid surgery chapter 21 anesthesia. Conservative vs superficial parotidectomy for benign. This is a teaching video for residents in head and neck surgery. A number of tumors can develop in the parotid gland. The mass itself can be found anywhere within the parotid gland. Your parotid glands are one of the glands that release saliva spit into your mouth. Prior surgery had been performed in cases 12% and prior radiation had been performed in three 3%. Postoperative infection is uncommon, and it is reported to occur in less than 3% of patients. After that procedure, the result remained very good on the aesthetic point of view for 11 months, until a weight loss of 17 kg leading to a. Partial superficial parotidectomy via retroauricular hairline. We compared two techniques of superficial parotidectomy.
The gland is removed to treat an infection that keeps returning or to take out a tumor. I strongly believe, however, in spite of the controversy between conservative and superficial lobectomy, that the manner in which the parotidectomy is performed is much more important than whether either a subtotal or superficial lobectomy is performed. The patients right face was then prepped and draped in the usual sterile manner. Identification of facial nerve during parotidectomy. Data on the principles and outcome of facial nerve reconstruction and reanimation after radical parotidectomy are limited and no consensus exists on the best practice. Parotid salivary gland removal, superficial parotidectomy.
Infection is uncommon because of the antibiotics that are used during and after surgery. The following list of warnings regarding parotidectomy is neither exhaustive nor is it predictive. They release saliva into your mouth through the parotid duct. After the steristrips are removed at the office on your followup appointment, gently wash the incision with soap and water two to three times a day as needed. The most common reason to remove this gland is due to an abnormal mass contained within. Facial nerve abnormality on parotidectomy for warthin. Lateral parotidectomy medical transcription sample report. Take as much time as you wish to read this information and ask questions of your doctor or the assistants.
After this is removed, you will be discharged home, although some patients are discharged home with a drain still in. Infection is avoided by adherence to sterile surgical technique and the careful handling of tissues intraoperatively. Sep 02, 2016 a minimally invasive procedure pioneered by dr. Parotidectomy definition of parotidectomy by medical.
Advance your surgical expertise with atlas of advanced operative surgery. The purpose of this study was to evaluate the usefulness of retroauricular hair line incision rahi in partial superficial parotidectomy by comparison with modified blair incision or facelift incision. You may also be prescribed a short course of antibiotics to take home. Baptist downtown southside baptist south possible risks and complications. We followed 11 patients who underwent parotidectomy 9 superficial and 2 total parotidectomies for a variety of parotid tumors between december 2001 and january 2018. Parotidectomy for a benign tumour is demonstrated in four steps. Professor and chair head and neck surgery mayo clinic parotidectomy 60 100 cases per year variety of neoplasms and anatomic variations minimal morbidity overall recurrent neoplasms challenging cases personal experience 32 years. Superficial parotidectomy was performed in 62 patients 57% and concurrent elective neck dissection was. Parotidectomy parotidectomy removal of a portion or all the parotid gland is a surgical procedure that takes approximately an hour and a half to complete, and patients can expect to leave four hours after their arrival.
Jun 03, 2016 tumors that extend into the deep lobe may require total parotidectomy. Partial superficial parotidectomy versus conventional superficial parotidectomy for benign parotid tumors. This study aimed to determine the indications of partial superficial. Parotidectomy is a major surgical procedure to remove the parotid gland shaded blue in the image which is one of 2 major salivary glands found in the human body. Promising technique for facial nerve reconstruction in extended parotidectomy. Partial superficial parotidectomy for pleomorphic adenoma khalid b alghamdi, md objective. Total parotidectomy was associated with a significantly higher incidence of facial nerve dysfunction during the first postoperative period 60. Your parotid glands are found in your cheeks, over your jaw and in front of your ears. A total of 89 parotidectomies were included and the results presented of a retrospective case study during a sixyear period. Purpose the main purpose of parotidectomy is to remove cancerous tumors in the parotid gland. Obrien cj current management of benign parotid tumors the role of limited superficial parotidectomy. At present, surgical excision is the most effective treatment for parotid tumors, but controversy remains with respect to the use of superficial parotidectomy sp or partial superficial parotidectomy psp. You need saliva to help with chewing and swallowing. As with any surgical procedure, there is a risk of bleeding, infection, scarring, and unforeseen complications.
Parotidectomy step by step approach ravi sachidananda. Many of these are tumors that have spread from other areas of the body, entering the. Partial superficial parotidectomy with retrograde dissection is a suitable method for benign appearing parotid tumors. Reviewing the use of checkpoint in revision parotidectomy. Variations of parotidectomy indications and technique kerry d. There are two of them, one on each side of the face and they produce saliva that drains into the mouth through a duct that lies next to the upper molar teeth. The most pertinent warnings have been included here.
Parotidectomy aftercare instructions what you need to know. Nov 27, 2014 the majority of lesions are benign and affect the superficial parotid lobe. The marginal mandibular branch was reported as the single most affected nerve branch following parotidectomy 48. Superficial parotidectomy superficial parotidectomy is a surgical procedure in which the part of the gland above the facial nerve is removed.
Atlas of advanced operative surgery 1st edition pdf. The procedure is most typically performed due to neoplasms tumors, which are growths of rapidly and abnormally dividing cells. This study aimed to determine the indications of partial superficial parotidectomy with extracapsular dissection and traditional superficial parotidectomy for the removal of pleomorphic adenoma. Total parotidectomy for cutaneous scc and melanoma jama. Partial superficial parotidectomy for pleomorphic adenoma.
Optimizing the aesthetic result of parotidectomy with a face. Feb 03, 2020 a parotidectomy is surgery to remove part or all of your parotid gland. Tumors that extend into the deep lobe may require total parotidectomy. May 28, 2003 current management of benign parotid tumorsthe role of limited superficial parotidectomy. This video demonstrates a total parotidectomy performed by dr. Parotidectomy parotidectomy is removal of part or all of the parotid gland, a salivary gland that lies in front of and below the ear. Nobody wants a big operation if a smaller one will do. Superficial parotidectomy involves identification of the facial nerve. Role of limited parotidectomy in management of pleomorphic. The effect of partial superficial parotidectomy on amplitude, latency and threshold of facial nerve stimulation. Although the incisional parotid biopsy is the diagnostic procedure of choice for systemic disease involving the parotid, the superficial parotidectomy remains the minimal biopsy of choice for a mass suspected to be a neoplasm in the parotid.
Definition parotidectomy is the removal of the parotid gland, a salivary gland near the ear. Medical records of 73 patients with benign parotid. Your parotid glands are found in your cheeks, over your jaw, and in front of your ears. Surgical procedure of partial superficial parotidectomy via the retroauricular hair line incision approach. In a partial superficial parotidectomy, only some branches of the facial nerve are usually dissected, whereas in a. The parotidectomy miniincision is a procedure to remove a parotid tumor with a small incision, allowing patients to recover more quickly. They consist of major and minor glands and ducts that drain secretions into the mouth. A superficial parotidectomy is the surgical removal of the superficial part of the parotid gland, which is a large salivary gland that lies near the facial nerve there are two parotid glands, one on each side of face near the ear. You will be asked to attend a preassessment appointment before surgery where we will assess your fitness to undergo an. Parotidectomy indications procedure postoperative care. Rare parotid salivary fistula post superficial parotidectomy.
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