Surgical technique superficial parotidectomy deep lobe parotidectomy surgeons will spend their entire career trying to learn when it is safe or necessary to do more or less than a superficial parotidectomy 6 superficial parotidectomy indications neoplasm risk of metastasis recurrent infectionabscess surgical exposure deep lobe. Operation is normally performed under general anesthesia with a nerve stimulator to facilitate facial nerve stimulation. Saliva drains from it through a tube that opens on the inside of the. This involves resection of the entire parotid gland, usually with preservation of the facial nerve. Your care at home after a parotidectomy home uw health. If you have any other questions that the leaflet does not answer or would like further explanation please ask a. Unlike the pleomorphic adenoma, it is more common in older white men and is the most likely to be bilateral in 10% of the cases. Before the 1940s, the simple surgical technique, enucleation, was a widely used operation because of shortages of understanding of parotid. One of the most technique sensitive surgeries in the maxillofacial region is the parotid gland surgery owing to the close relation between the gland and the extracranial course of facial nerve. Neoplasms can be benign noncancerous or malignant cancerous.
The gland is removed to treat an infection that keeps returning or to take out a tumor. Though in the past, the parotidectomy recovery time could be quite extensive, new procedures have made this surgery minimally invasive and recoveries very predictable. The very surgery is performed in order to remove tumors from the gland. Partial superficial parotidectomy via retroauricular hairline. However, in the last two decades, psp or ecd techniques were employed to remove the tumor along with a cuff of healthy tissue around it, while preserving the rest of the parotid gland12,1423.
Thirty two patients with benign parotid tumors were included in this study. Sep 26, 2016 superficial lobe parotidectomy if the tumor is located on top of the facial nerve it is called a superficial lobe parotid tumor. In our case we made the accurate diagnosis of warthins tumor in a short period of time and performed superficial parotidectomy without delay. As with any surgical procedure, there is a risk of bleeding, infection, scarring, and unforeseen complications. Parotidectomy discharge care what you need to know. Larian has been able to perfect the microparotidectomy technique and he performs this minimally invasive procedure whenever possible. This approach leaves scarring and facial contour deformities. This gland makes saliva, which enters the mouth through a tube duct near the back teeth.
If the tumor is located on top of the facial nerve it is called a superficial lobe parotid tumor. The traditional parotidectomy surgery and facelift incision do. Typically, long facial incisions are used to gain access. Most tumors that grow in the parotid gland are benign. Parotid salivary gland removal, superficial parotidectomy. Microparotidectomy is a minimally invasive parotid surgery procedure pioneered by.
This incision heals well with minor scarring and provides safe access to identify the facial nerve and remove all tumor tissue. Both procedures will be done at the same time and will involve two different entry points cuts in order to gain access to. This elearning course provides a step by step approach, lessons on objectives, preoperative information and postoperative complications, procedural anatomy and a test. The operation is performed under general anaesthetic and lasts four to six hours. In some cases, after taking out a parotid gland tumor, the facial nerve may be. Variations of parotidectomy indications and technique. Parotidectomy procedure pdf the facial nerve is central to parotid surgery for both surgeon and patient. Major complications include facial nerve paresis or paralysis, and minor complications include salivary fistula, auriculotemporal syndrome gustatory sweating or frey syndrome, great auricular nerve anesthesia, and hemorrhage. Your parotid glands are found in your cheeks, over your jaw, and in front of your ears. Traditionally, superficial parotidectomy is the standard technique employed to resect parotid adenomas1,3,1214. Baptist downtown southside baptist south possible risks and complications.
This gland is encased in parotid fascia superficial layer of the deep cervical fascia. Partial superficial parotidectomy via retroauricular. Facial nerve is generally located by means of a proximal surgical identification technique aimed at identifying the facial nerve at its point of exit from the stylomastoid foramen to its entry into the. Parotidectomy is a surgical operation to remove a large salivary gland the parotid gland located in front and just below the ear. Pdf pleomorphic adenoma is the commonest tumor of the parotid gland and. Proximal and distal facial nerve exploration during. Purpose the main purpose of parotidectomy is to remove cancerous tumors in the parotid gland. Nov 27, 2014 the aim of the present study was to compare the outcomes of superficial parotidectomy sp and partial superficial parotidectomy psp in treating benign parotid tumors. The extended parotidectomy is a complex surgery reserved, generally, for the advanced parotid malignant lesions that interest several anatomical structures, with the objective of eradicating.
Extracapsular dissection versus superficial parotidectomy. Parotidectomy definition of parotidectomy by medical dictionary. Warthins tumor benign papillary cystadenoma lymphomatosum is the second most common benign tumor of the parotid gland. A complete template operative dictation note is provided. Autologous fat transfer was primarily used in 10 cases to. The stigma of a visually prominent facial scar following parotid surgery can be. Parotidectomy plastic surgery for facial deformity correction. Feb 03, 2020 a parotidectomy is surgery to remove part or all of your parotid gland. Superficial muscular aponeurotic system and parotid fascia. Learn about the parotidectomy, an online 3dvideobased course, accredited by the royal college of surgeons of england. The current study aimed to compare extracapsular dissection ed versus superficial parotidectomy sp in surgical treatment of benign parotid tumors. In partial superficial parotidectomy, only the tumourbearing area of the gland parenchyma. Both procedures will be done at the same time and will involve two different entry points cuts in order to gain access to the lymph nodes that need to be removed. The incision is usually closed with nylon sutures that are removed.
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. Parotidectomy under general anaesthesia a case report. How is a neck dissection and superficial parotidectomy performed. Aug 24, 2010 operative technique of superficial parotidectomy by dr. The flash presentation below illustrates the surgical steps in a parotidectomy.
A parotidectomy is the surgical excision removal of the parotid gland, the major and largest of the salivary glands. Create a modified blair figure 1 or facelift incision. Parotidectomy is the removal of the parotid gland, a salivary gland near the ear. Wiring the tube to the existing dentition, if present, is another option. Surgery in superficiallobe pleomorphic parotid adenoma. Definition parotidectomy is the removal of the parotid gland, a salivary gland near the ear. Several procedures have been described to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. A number of tumors can develop in the parotid gland. The aim of the present study was to compare the outcomes of superficial parotidectomy sp and partial superficial parotidectomy psp in treating benign parotid tumors. Accessory parotid gland tumors are located in difficult to reach areas of the face. In clinical practice this procedure ca n be performed by general surgeons, oto. The parotid gland is a gland that makes saliva spit. Microsurgical dissection of facial nerve in parotidectomy. The majority of parotid gland tumors are benign, however 20% of parotid tumors are.
Superficial parotidectomy versus extracapsular dissection. Nursing teaching for parotidectomy iowa head and neck. It is important to confirm that the patient has regained full motor function as determined by twitch monitoring before attempting to dissect out the. Brought to you by serona health private limited 9703977769. Larian is able to access the parotid gland using a very small incision with the minimally invasive parotid surgery technique.
This chapter lists the indications, essential steps, variations in technique, and complications of this procedure. Some are treatable and not so serious while others can lead to permanent damage. In particular with neck surgery there is a risk of. Superficial parotidectomy versus retrograde partial superficial. This article describes a hitherto undescribed technique of administering local anesthesia to undertake a superficial parotidectomy. Partial superficial parotidectomy for pleomorphic adenoma. Patients who need a parotid tumor removed may have many questions regarding facial surgery. Technical modifications based on tumour characteristics article pdf available in journal of craniomaxillofacial surgery 326. Parotidectomy with facial nerve dissection iowa head and neck. 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.
A video presentation of right superficial or lateral parotidectomy. Top 10 benefits of minimally invasive parotid surgery. Parotidectomy with or without facial nerve removal is performed without delay4, 5. To allow adequate monitoring of the facial nerve, paralytics should not be used beyond the induction of anesthesia. As advances in parotid tumor surgery have been made, dr. The parotid gland is the largest of the salivary glands. Operative technique of superficial parotidectomy by dr. Patientfamily will verbalize understanding of routine preoperative instructions. Nursing teaching for parotidectomy iowa head and neck protocols. This study examined whether current surgical techniques improved functional outcomes after surgery for benign parotid tumours. Parotidectomy parotid surgery technique mouseover picture to outline facial nerve. This is the largest salivatory gland localized near the eye. Parotidectomy, a surgical procedure to treat benign and malignant diseases of the parotid gland, has welldocumented postoperative complications 1,2. Parotidectomy is a common procedure usually done for a parotid mass necessitating a histological diagnosis.
Parotidectomy is a surgical removal of parotid gland. This surgery, which removes the parotid gland, helps people with nerve issues, tumors, and other gland problems. The most common indications for this operative procedure are a neoplasm of the superficial lobe of the parotid gland, metastases to parotid lymph nodes. We describe a new technique with reports of three cases, making total parotidectomy under local anesthesia possible. Pronunciation of parotidectomy with 1 audio pronunciation, 2 translations and more for parotidectomy. The technique is based on precise nerve blocks keeping in mind the regional nerve supply and the facial dermatomes. Parotidectomy parotidectomy is done under general anesthesia through an incision that courses just in front of the ear and into the neck. Parotidectomy is surgery done to remove all or a part of your parotid gland. Purpose the parotid gland is the largest of the salivary glands. Surgical techniques have evolved over the years, with superficial parotidectomy and extracapsular dissection being the current procedures of. Cal technique of parotidectomy via a facelift incision is described and evaluated. A parotidectomy is surgery to remove part or all of your parotid gland. Local anesthesia for parotidectomy a new technique.
The parotidectomy procedure is the modern patient choice for parotid tumor removal. The facial nerve is central to parotid surgery for both. The transoral approach eliminates all facial incisions. Many of these are tumors that have spread from other areas of the body, entering the. Jan 30, 2019 parotidectomy is typically performed with the patient under general anesthesia. This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions. The procedure is most typically performed due to neoplasms tumors, which are growths of rapidly and abnormally dividing cells. The main reason for a parotidectomy is to remove abnormal growths that. They release saliva into your mouth through the parotid duct. 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. Describe procedure, incision, facial nerve dissection.
Oral endotracheal intubation with either a conventional tube or a rightangle endotracheal tube is preferred. A duct through which saliva is secreted runs from each gland to the inside of the cheek. Superficial parotidectomy versus partial superficial. 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. There are two parotid glands, one on each side of the face, just below and to the front of the ear. The microparotidectomy is the most minimally invasive technique available and involves a minute incision near the ear to minimize scarring, recovery time and longterm complications. Salivary glands distributed throughout the neck and oral cavity provide saliva to aid in digestion. While removing tumor, the critical part of the surgery is to protect and preserve all the facial nerves that are crucial to many facial functions. Table 3 types of surgical technique according to tumour location.
Parotidectomy definition of parotidectomy by medical. Azizzadeh, as we have found that a team approach to this surgery provides. At the center, every microparotidectomy is performed by both dr. Although damage to the facial nerve when transversing the gland is the main complication, gustatory sweat syndrome, also known as freys syndrome, should be. Parotidectomy is the removal of the parotid gland, located below the ear. In this procedure, the superficial lobe is completely resected and the integrity of the facial nerve anat. Superficial parotidectomy is performed to remove tumors of the superficial lobe of the parotid gland and may be rarely performed during lymphadenectomy for melanoma.
Conservation of salivary secretion and facial nerve function in partial. Surgical techniques of repair ben nageris, md, raphael feinmesser, md every surgical procedure has its price, and so does resection of parotid tumors. The parotid gland is a salivary gland that lies immediately in front of the ear. Parotidectomy is typically performed with the patient under general anesthesia. In particular with neck surgery there is a risk of damage to multiple nerves in the head and neck area. The video on the right shows the surgical technique used to preserve the facial nerve using the starion entcepts. Apr 04, 2016 superficial parotidectomy technique duration. Superficial parotidectomy involves removing all of the gland superficial to the facial nerve to treat superficial parotid tumors. Extracapsular dissection versus superficial parotidectomy for. Sep 22, 2010 one of the most technique sensitive surgeries in the maxillofacial region is the parotid gland surgery owing to the close relation between the gland and the extracranial course of facial nerve.