Parotidectomy (Parotid Gland Surgery)

What Is the Parotid Gland?

The parotid glands are the largest salivary glands, located just in front of and below each ear. They produce saliva, which helps with chewing, swallowing, and digestion.

Why Is Surgery Needed?

Parotidectomy is typically recommended when a growth or mass is present in the parotid gland.

Most tumors are benign (non-cancerous), but some may be cancerous. Surgery may be recommended to:

• Remove the mass
• Prevent growth or spread
• Establish a definitive diagnosis
• Relieve symptoms such as swelling or discomfort

What Is a Parotidectomy?

A parotidectomy is a surgical procedure to remove part or all of the parotid gland, depending on the size and location of the mass.

How Is the Procedure Performed?

• Performed under general anesthesia
• An incision is made in front of the ear and may extend into the neck, typically along natural skin creases
• The facial nerve is carefully identified and preserved
• The affected portion of the gland is removed
• A drain may be placed to prevent fluid accumulation

Duration: Approximately 1-3 hours, depending on complexity

What to Expect After Surgery

• Same-day discharge or rarely, overnight hospital stay
• Mild pain, swelling, and tightness are common
• Temporary numbness around the ear or cheek may occur
• Drain (if placed) is usually removed within a few days

Recovery

• Return to normal activities: 1–2 weeks
• Return to work: typically 7–14 days
• Final pathology results: usually within 1 week
• Incision heals well, and the scar fades over time

Benefits of Surgery

• Removal of tumor or abnormal tissue
• Accurate diagnosis
• Prevention of progression
• Symptom relief

Risks and Potential Complications

• Temporary facial weakness (rarely permanent)
• Numbness of ear or face
• Bleeding or infection
• Fluid collection (seroma or hematoma)
• Frey’s syndrome (sweating in the cheek while eating)

Post-Operative Instructions

How You Will Feel

You may feel drowsy and tired the day of surgery. Fatigue may persist the following day but should improve quickly. Light activity is encouraged to aid recovery.

Nausea

Mild nausea can occur despite preventative medications.

• Stick to clear liquids initially
• Avoid heavy foods
• Symptoms usually resolve within 12–24 hours

Pain / Discomfort

• Mild discomfort around the incision and neck is common
• Use prescribed pain medication as directed
• Transition to acetaminophen (Tylenol) after 1–2 days if appropriate

Swelling

• Swelling and mild discoloration are expected
• May increase during the first 24 hours
• Apply ice packs for the first 48 hours
• Sleep with head elevated
• Most swelling improves within 4–5 days

Fever

• Low-grade fever (up to 101°F) is common
• Call if fever reaches 102°F or higher and does not respond to acetaminophen (Tylenol) or ibuprofen (Motrin)

Antibiotics / Infection

• Antibiotics may be prescribed
• Infection is rare
• Call if you notice:
  • Increasing redness
  • Swelling with tenderness
  • Fever

Activity

• Light activity as tolerated
• Avoid heavy lifting for at least 1 week
• Avoid strenuous exercise for 2 weeks

Diet

• No specific restrictions
• Advance diet as tolerated

Incision Care

• Closed with sutures or Dermabond
• Dermabond peels off in 7–10 days
• Keep incision clean and dry

Drain Care

• A drain is often placed to remove fluid
• Record daily output
• Follow-up in 2–3 days for removal

Hygiene

• Shower once drain is removed
• Clean gently with soap and water

Numbness

• Common around ear and cheek
• Cheek sensation usually returns over weeks to months
• Earlobe numbness may be permanent but often improves

Facial Weakness

• Temporary weakness may occur, usually mild
• Most commonly affects the corner of the mouth
• Typically resolves within weeks

Rare Eye Involvement:

• If unable to close the eye:
  • Use artificial tears during the day
  • Apply ointment at night
  • Tape eyelid closed while sleeping

Permanent weakness is very rare and treatable if needed.

Other Potential Issues

• Frey’s Syndrome: sweating in the cheek while eating
• Hematoma/Seroma: fluid collection requiring prompt evaluation
• Keloid formation: more common in prone individuals
• Earlobe asymmetry: may occur depending on healing

Follow-Up

• Drain removal: 2–3 days after surgery
• If no drain: follow-up in 1 week
• Confirm appointment with your surgery coordinator

When to Call the Doctor

• Fever over 102°F not responding to medication
• Sudden increase in swelling
• Difficulty breathing

Emergency Room

• If you need to go to the Emergency Room, please use the following guidelines
• Age 16 and older: Centennial Medical Center Frisco
• Under age 16: Children’s Medical Center Plano