Parotidectomy surgery involves the removal of part or all of your parotid gland in order to remove a lesion with adequate surgical margins. The facial nerve, which controls all the muscles of facial expression on one side of the face, travels through the parotid gland. Careful identification and protection of the nerve is an essential part of parotid surgery. Dr Tan-Gore utilises intra-operative nerve monitoring and surgical magnification loupes as aids during the operation. Temporary nerve injury may occur due to traction on the nerve during surgery but permanent nerve injury is rare (<1%).
The surgery is performed under a general anaesthetic. A long-acting local anaesthetic is infiltrated into the skin incision to minimise pain in the immediate post-operative phase. The incision extends in a natural crease line from in front of the ear to the mid-neck.
The facial nerve is identified and the parotid lesion is careful dissected away from the nerve.
A drain is placed which comes through the neck into a reservoir.
An overnight stay in hospital is expected. This is occasionally be extended if there is substantial drain amount or significant pain.
Dr Tan-Gore will review you in 1-2 weeks to give you the results of the excision of lesion, check your nerve function, monitor the incision scar and address any post-operative issues that may develop.
Most patients will require 1-2 weeks off work.
POST OPERATIVE INSTRUCTIONS
You will have pain and swelling in the post-operative period. This usually peaks at day 3-5 with a gradual improvement in your symptoms after that.
You will be given a script for analgesia. Dr Tan-Gore advises that you take the pain relief on a regular schedule for the first 5-7 days, even if you do not feel like you need it. This will ensure that you remain comfortable and minimise breakthrough pain that may require more significant analgesia. Consider setting a timer to remind yourself.
You will be given a script for antibiotics. Dr Tan-Gore recommends you take the full course, which will last for 5 days. This is to prevent infection.
You should be able to eat a normal diet. Some patients may find it more comfortable to have a soft diet for a few days. Ensure that you drink plenty of fluids, even if you do not feel like eating.
Your wound will be covered by a waterproof dressing (adhesive tape or dermal glue) which allows you to shower and wash your hair. Carefully dry your skin afterwards. Do not immerse your wound in water (e.g. bath or swimming pool) for 1 week.
After the wound has healed, you will be encouraged to massage the wound to help flatten the scar.
Do not expose your wound to the sun. Apply sunscreen with a high SPF when outdoors.
Gentle exercise is recommended during the first week after your surgery.