Parotid Gland Surgery

To diagnose problems with your parotoid glands, your providers will do a physical exam and ask you about your medical history. Then, they’ll check for lumps and see how well your facial nerves respond to being touched. They’ll also do imaging tests to get detailed views of your parotid glands. You may have a:

• CT scan.
• MRI.
• PET scan.
• Ultrasound.

If needed, we’ll also remove a small sample of tissue (biopsy) from your parotid gland and look at it under a microscope to see if tumors are benign or cancerous.

Meet Our Parotid Gland Tumor Team

Tumors, stones (calcium deposits), swollen salivary glands (sialadenitis) or, more specifically, a swollen parotid gland (parotitis), can cause the glands to stop making saliva. To figure out what’s causing this, you’ll work with a team of providers who’ll find out what the problem is and do surgery to fix it. This team could include:

• Otolaryngologists.
• Surgeons.
• Radiologists.
• Pathologists.
• Physician assistants.
• Nurse practitioners.

Your parotid gland includes two lobes — superficial and deep. The superficial lobe is at the outside of your gland. Parotid gland tumors most often develop in this lobe, where they’re less likely to involve your facial nerve.

This nerve runs through your entire parotid gland. It controls your facial movements and sense of taste. If a tumor develops in the deep lobe, the risk of nerve damage is higher during parotid gland surgery.

There are two main types of parotid gland surgery. Depending on your condition, your provider may recommend:

Sialendoscopy

This minimally invasive procedure is common and doesn’t require large incisions (cuts). Your surgeon will insert an endoscope (thin, flexible tube) into the affected salivary gland to get a good look at it. Then, they’ll use tiny tools remove any stones or tumors, or treat recurrent parotid gland irritation and dryness.

Parotidectomy

A parotidectomy can be complex. That’s why our head and neck surgeons will work with you to design a personalized treatment plan aimed at removing the tumor or blockage in your gland in a way that helps protect your facial nerve, preserve your appearance and let your salivary glands keep making spit.

Depending on which parotid gland lobe contains a tumor and the results of your tests, you may have:

• Superficial parotidectomy: Your surgeons will remove tumors from the superficial lobe.
• Total parotidectomy: Despite the name, in a total parotidectomy we typically only remove parotid tissue that’s deep in the facial nerve, and some of the surrounding tissues when tumors contain cancer cells. It’s rare to remove the entire parotid gland.

Right before your surgery, we’ll give you general anesthesia to put you to sleep during your parotid gland surgery. Your surgeons will make an incision near your ear that extends towards your neck to reach your parotid gland. This incision is similar to the incision used for facelifts and typically heals nicely.

Sometimes, your surgeon might need to remove a large amount of tissue. If so, they’ll do reconstructive surgery, possibly using bone, nerves or tissue from another part of your body to rebuild the area.

Recovering From a Parotidectomy

After surgery, you’ll stay in a recovery area where we can check your breathing, blood pressure and heart rate as you wake up from anesthesia. We’ll have you make certain facial movements, like smiling or closing your eyes, to check how well your facial nerves work.

You might stay in the hospital overnight, but often, you’ll go home the same day as surgery. Before we send you home, your healthcare provider will go over what you can expect during your recovery.

Recovering from parotid gland surgery at home may take several weeks to a month. You might have facial numbness and weakness that could take a few months to a year to go away.

During your recovery, you’ll have follow-up appointments with your healthcare provider to make sure you’re healing well and to check for complications.

Not everyone has complications after parotid gland surgery. But you may experience:

• Facial sweating while eating (Frey’s syndrome).
• Facial numbness in your parotid gland area.
• Permanent ear lobe numbness.
• Pain when taking your first bite of food (first bite syndrome).

If your tumor was cancerous, we may recommend more treatments to destroy any cancer cells that may still be there after parotid gland surgery. You may work with our oncologists and have chemotherapy and/or radiation therapy.

Taking the Next Step

We know the thought of having surgery on your face can be unsettling — especially when it’s near the nerve that controls your smile and helps you taste delicious food. But removing tumors or blockages in your parotid gland can help you make the right amount of saliva and stay healthy. At Cleveland Clinic, we’ll support you through your parotid gland surgery and help you have a healthy recovery.