Information on removal of the parotid sinus / parotidectomy
Introduction
The purpose of this information is to provide you with generally applicable information about this type of operation. Of course, certain aspects of this document are not applicable in your individual case or should be discussed more or additionally with your surgeon. Remember to report to your surgeon all information regarding your general health, as well as any medications you regularly take (especially aspirin and related products, or other medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring any recent medical records in your possession, such as blood results, radiologic and other preoperative exams.
The parotid gland (parotid gland) is located in front of and below the ear. There are 2 parotid glands, 2 under the jaw and 2 under the tongue. Together with numerous smaller salivary glands, they ensure saliva production. The parotid gland has a superficial and a deep lobe, between which runs the facial nerve (facial nerve). This ensures the mimicry of the face, the closing of lips and eyelids. When a tumor is found, it is best removed surgically. Most growths are benign.
Purpose of the procedure
When a tumor of the parotid gland needs to be removed, it is safe to do so after carefully locating the facial nerve to try to avoid facial paralysis.
The technical aspects of the operation
The operation is done under general anaesthetic. Through an incision, which runs in front of the ear and further into the neck, the parotid gland, the facial nerve and the tumor are searched for and the tumor is removed. Depending on the location and extent of the injury, the operation can take up to 4 hours. When you wake up, there is a drain at the bottom of the wound, through which excess wound fluid and saliva can drain. The drain is removed after 3 days, when no more fluid drains. By incising the skin and removing the tumor, the sensory nerve that supplies the earlobe and neck cannot be spared. After the operation, there is a numbness of the earlobe and the area of operation. The numb area gradually becomes smaller and smaller.
The immediate consequences
Swelling usually occurs in the wound area for several weeks. There may be bleeding from the wound. This usually happens shortly after the operation. Sometimes it is necessary to find the source of bleeding again under anesthesia and to burn the bleeding vessel shut. A crooked face may occur after surgery due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months).
The belated consequences
There may be a collection of saliva previously visible at the bottom of the wound, which may need to be punctured. Frey's syndrome can develop after a few months. Then there is redness and perspiration of the skin of the operating area during eating.
Serious and/or late complications
Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. Permanent facial nerve failure can occur but is extremely rare. Phlegmon or abscess formation in the neck area is rare. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated.
Wanneer is een operatie nodig?
Bij ontsteking van de cyste, bij groei met klachten zoals slik- of ademhalingsproblemen, of wanneer de cyste cosmetisch stoort.
Wat is het doel van de operatie?
De cyste volledig verwijderen en herval voorkomen.
Hoe verloopt de ingreep (Sistrunk-procedure)?
Onder algehele narcose maakt de chirurg een kleine incisie in een huidplooi van de hals om het litteken te beperken, en maakt de cyste los van het omliggende weefsel. Om herval te voorkomen wordt ook een deel van het tongbeen verwijderd, samen met het weefsel tussen cyste en tongbasis — dit heet de Sistrunk-procedure. De ingreep duurt gemiddeld 1 tot 2 uur.
The immediate consequences
The wound area usually experiences swelling for a few weeks. There may be post-operative bleeding from the wound. This usually occurs shortly after the operation. Sometimes it is necessary to find the bleeding site again under anesthesia and to cauterize the bleeding vessel. After the operation, a crooked face may occur due to manipulation of the nerve during the procedure with (temporary) paralysis of the facial nerve. The paralysis usually recovers after some time (weeks to months).
The late consequences
There may be a collection of saliva visible at the bottom of the wound, which may need to be punctured. After a few months, Frey's syndrome may develop. Redness and perspiration of the skin of the surgical area will occur during eating.
Serious and/or late complications
Every surgical procedure, even in ideal circumstances and performed in the best possible way, can have complications. Permanent failure of the facial nerve can occur but is extremely rare. Phlegm or abscess formation in the neck area is rare. All these risks must be weighed against complications that can occur if surgical treatment is not resorted to.