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5 Important Questions About Parotidectomy Answered

The parotid gland is the largest and one of the three major glands that make up the salivary glands. Each person has two, and they’re located just in front of each ear.. The function of these glands is to produce watery serous saliva, which aids in chewing and digestion, as well as in keeping the mouth lubricated. The parotid glands contain serous acini—a secretion that contains modified proteins that are stored in secretory or zymogen granules.

Read more: 5 Important Questions About Parotidectomy Answered

To keep our parotid glands healthy, we need to stay hydrated and maintain good oral hygiene. Refraining from smoking and limiting alcohol consumption also helps. Nevertheless, the parotid glands can develop certain conditions and diseases that may require the individual to undergo parotidectomy. To get a better understanding of this procedure, and its importance, this article aims to answer five important questions.

What Is Parotidectomy?
Parotidectomy is a major surgical procedure aimed at addressing conditions affecting the parotid gland. It involves the removal of a part or the entirety of the parotid gland to treat various medical conditions. The procedure is typically performed by skilled surgeons who specialise in head and neck surgeries. The average parotidectomy takes around three to four hours to complete.

Why Would Someone Need to Undergo Parotidectomy?
Parotidectomy becomes a necessary surgical option for individuals facing specific parotid gland issues that may not be effectively managed through non-surgical treatments. Let’s have a look at some of these reasons:

Tumours. One of the primary indications for parotidectomy is the presence of tumours within the parotid gland. These tumours can be either benign or malignant. Benign tumours, such as pleomorphic adenomas, may necessitate surgical removal, especially if they grow large enough to cause symptoms or if there is a risk of complications. Malignant tumours, including various types of cancers, often require more extensive parotidectomy procedures to ensure complete removal and reduce the risk of recurrence and metastasis.

Chronic Infections. Chronic infections of the parotid gland may require surgical intervention if conservative measures, such as antibiotics and good oral hygiene, prove ineffective. Parotidectomy can be performed to remove the affected tissue and alleviate symptoms associated with recurrent infections, such as swelling, pain, and difficulty in swallowing.

Salivary Stones (Sialolithiasis). Salivary stones (or sialolithiasis) occur when hardened mineral deposits form in the salivary glands in the parotid duct. This condition can lead to chronic swelling, pain, and recurrent infections, and although the main cause of it is unknown, factors, such as dehydration, smoking, and gum diseases, are associated with salivary stone formation.
In cases where non-invasive treatments are insufficient, parotidectomy may be recommended to address the underlying issue. Surgical removal of the affected portion of the gland or the entire gland can be performed to prevent further stone formation.

Inflammatory Conditions. Inflammatory conditions that impact the parotid gland, such as those associated with autoimmune disorders like Sjögren’s syndrome, may necessitate parotidectomy. Removal of the inflamed tissue becomes essential in managing symptoms and preventing complications associated with chronic inflammation.

Are There Different Types of Parotid Surgeries?
Yes. There are various types of parotid surgeries, and each one is tailored to address specific conditions and considerations. Here are some of the different types:

Total Parotidectomy. Total parotidectomy involves the removal of the parotid gland, as well as the superficial and deep lobes. This extensive procedure is typically reserved for cases where the entire gland is affected.

Superficial Parotidectomy. Superficial parotidectomy is the most common type of parotid surgery, and it involves the removal of only the superficial lobe of the parotid gland. It’s often employed for treating benign tumours, chronic infections, and other conditions primarily affecting the superficial part of the gland.

Partial Superficial Parotidectomy. This type of parotidectomy requires the removal of a portion of the superficial lobe of the parotid gland. It may be considered when the affected area is localized, and preserving as much healthy tissue as possible is a priority.

Extended Superficial Parotidectomy. Extended superficial parotidectomy is a more
comprehensive approach that not only removes the superficial lobe but also adjacent tissues that may be affected. This type of surgery is typically considered in cases where the condition has spread beyond the confines of the parotid gland.

Nerve-Sparing Parotidectomy. In this surgery, surgeons aim to protect the facial nerve while still addressing the underlying condition. This can involve careful identification and dissection of the nerve to minimize the risk of damage.

What Are the Special Instruments and Equipment Used in This Procedure?
Parotidectomy is a delicate surgical procedure that requires precision and careful management of vital structures. To ensure the success of the surgery and the well-being of the patient, surgeons employ special instruments and equipment designed for these intricate tasks. Apart from common surgical instruments, such as scalpels, scissors, retractors, and haemostatic clamps, surgeons will also use the following key tools and devices:

Facial Nerve Monitoring System. One of the critical considerations during parotidectomy is the preservation of the facial nerve, which controls facial expressions. To achieve this, surgeons often utilise a facial nerve monitoring system. This system allows real-time monitoring of the facial nerve’s function during surgery, allowing surgeons to adjust their approach to protect the facial nerve and reduce the risk of postoperative facial weakness or paralysis.

Microscope or Loupes. When dealing with small structures and delicate tissues, surgeons may use a microscope or loupes (magnifying lenses worn like glasses) to enhance their visual acuity. These tools aid in better visualizing the surgical site, facilitating meticulous surgery with minimal damage to surrounding structures.

Drainage Systems. Surgical drainage systems are used to prevent the accumulation of excess fluid around the surgical site. Fluid build-up can lead to complications, such as haematomas or seromas, and with these systems in place, they reduce the risk of complications and promote a smoother recovery.

What Happens During a Parotidectomy?
Before the surgery officially starts, an anaesthesiologist administers the right amount of anaesthesia to the patient so that they remain unconscious and pain-free throughout the procedure. Next, the surgeon will clean the surgical site using antiseptic solutions before an incision is made. The incision for parotidectomy is often done along a natural skin crease to access the parotid gland. Once the incision is made, the surgeon removes the affected portion or the entire gland, taking care to avoid damage to the facial nerve. After the removal, the incision is closed with sutures and the surgical wound is cleaned.

For instances where non-invasive measures can’t solve parotid gland issues, doctors might recommend parotidectomy to restore a patient’s quality of life. If you want to make sure that your parotid glands are healthy, consult a medical professional so that they may give you an accurate assessment.

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