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