The facial nerve — which controls all muscles of facial expression — runs directly through the parotid gland, making identification and preservation of this nerve the most crucial step of the entire procedure.
Parotidectomy is performed for a wide range of conditions, from slow-growing benign tumors like pleomorphic adenoma to malignant parotid cancers, chronic infections, and salivary duct obstruction.
The proximity of the facial nerve to the parotid gland means that this surgery should only be performed by a surgeon who operates on the parotid frequently — experience directly reduces the risk of nerve injury.
A visible or palpable lump in the cheek or just below the ear — often painless and slow-growing — is the most common presenting sign of a parotid gland tumor or enlargement.
A growing parotid tumor can press on surrounding structures, causing dull aching pain or pressure around the cheek, ear, or jaw that progressively worsens over time.
Any weakness, drooping, or asymmetry in the face associated with a parotid lump may indicate malignant involvement of the facial nerve — requiring urgent specialist evaluation.
Tumors in the deep lobe of the parotid gland can press inward toward the throat and jaw joint, causing difficulty chewing, swallowing, or fully opening the mouth.
Tingling or numbness of the earlobe and skin around the ear can result from pressure on the great auricular nerve — a sensory nerve closely related to the parotid gland.
Repeated episodes of painful swelling near the ear or cheek — especially around mealtimes — may indicate chronic parotid infection (sialadenitis) or a salivary duct stone causing recurrent obstruction.
A previously stable parotid swelling that suddenly begins growing rapidly should be evaluated urgently for possible malignant transformation.
The most common reason for parotidectomy — a slow-growing, painless benign tumor that accounts for the majority of parotid lumps. Surgical removal is recommended as it can undergo malignant transformation if left untreated for years.
The second most common benign parotid tumor, almost exclusively occurring in the parotid gland — often seen in older men and smokers, sometimes bilateral, and requiring surgical excision.
Mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma are among the most common malignant parotid tumors — requiring oncological resection with clear surgical margins.
Recurring bacterial infections that fail to resolve with antibiotics can lead to permanent gland damage — surgical removal eliminates the source of chronic infection and pain.
When salivary stones or strictures in the parotid duct cannot be managed with minimally invasive methods, removal of the gland may be necessary to resolve the obstruction permanently.
A detailed clinical examination combined with ultrasound, MRI or CT scan, and fine needle aspiration cytology (FNAC) precisely characterizes the tumor — confirming whether it is benign or malignant and guiding the surgical approach.
When the tumor is confined to the superficial lobe of the parotid gland, only that portion is removed — the incision runs in front of the ear, down to the neck, and along the jawline, designed to minimize visible scarring.
When the tumor involves the deep lobe or both lobes of the gland, the entire parotid gland is removed — performed with meticulous dissection to protect the facial nerve throughout the procedure.
Continuous intraoperative facial nerve monitoring using electromyography (EMG) ensures real-time feedback during surgery — significantly reducing the risk of accidental nerve injury and preserving facial movement.
When malignant parotid tumors have spread or are at risk of spreading to the lymph nodes in the neck, a concurrent neck dissection is performed to address regional disease comprehensively.
For suitable cases, a smaller, well-hidden incision near the ear is used to remove the tumor with reduced scarring, less postoperative pain, and faster recovery — without compromising surgical safety.
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Thorough examination of your jaw, bite, muscles, and joint plus review of imaging if available.
Clear explanation of your diagnosis with a personalized, staged treatment roadmap.
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