Parotidectomy

Parotidectomy is the partial or complete removal of the parotid gland; the procedure may be indicated for various reasons, including inflammatory conditions, certain infectious processes, congenital malformations, and benign or malignant neoplasms.

The parotid gland is a primarily serous salivary gland that is located high in the neck in the preauricular area extending towards the cheek. The extratemporal facial nerve and its branches pass through the parotid gland and supply motor innervation to the muscles of facial expression, as well as to the postauricular muscles, the posterior belly of the digastric muscle, and the stylohyoid muscles.

Indications

Neoplasms are the most common indication for parotidectomy. The vast majority of primary parotid tumors are benign, but approximately 20% are found to be malignant. In addition, regional and distant disease can metastasize to the parotid and necessitate removal for diagnosis or cure.

Inflammatory processes (eg, chronic parotitis, deep salivary calculi, or parotid abscess) are occasionally treated with total parotidectomy, with the recognition that surgery in an inflamed gland probably carries a higher risk of postoperative facial nerve dysfunction. [1] Salivary duct stones may be approached through minimal external paortid incisions, and are aided by sialendoscopy when possible. For further information on the workup and treatment of parotid sialadenitis and calculi, see Parotitis.