Removal of the parotid salivary gland
Information for patients from the British Association of Oral and Maxillofacial Surgeons (BOAMS)
This leaflet has been designed to answer some of the common questions patients have about this treatment option. It is not meant to replace the information discussed between you and your doctor, but can act as a starting point for such a discussion or as a useful reminder of the key points. If after reading this leaflet you still have questions, please ask a member of staff.
What is the parotid gland?
The parotid gland is a salivary gland that lies immediately in front of the ear. Saliva drains from it through a tube that opens on the inside of the cheek, next to the upper back teeth.
The parotid gland is most commonly operated on to remove a lump.
What does the operation involve?
The parotid gland is removed under general anaesthesia (you are asleep).
The operation involves making a cut immediately in front of your ear. This cut is extended either downwards into your neck or behind your ear. Once the gland has been removed the cut is held together again with stitches. These need to be removed around a week after surgery.
At the end of your operation a small tube is also placed through your skin into the wound to drain any blood which may collect. This is usually removed on the morning following your surgery.
Will anything else be done while I am asleep?
If your gland is being removed because of infection that is caused by a stone, it may also be necessary to make a cut inside your mouth to remove that stone.
How long will the operation take?
Removal of all or part of the parotid gland is a complicated operation which takes approximately two hours.
What can I expect after my operation?
You usually need a night in hospital following your surgery.
You are unlikely to feel very sore but regular painkillers will be arranged for you.
There is a little swelling following parotid gland removal.
Since part of the gland is taken away it can leave a dent under your skin.
Do I need any time off work?
We usually advise you to take a week off from work to recover from your surgery. During this time you should avoid strenuous activity.
Is there anything that I need to do when I get home?
It is important to keep your wound dry for the first week following surgery; you will need to take care when washing or shaving.
Will I have a scar?
All cuts made through the skin leave a scar but most of these fade with time and are difficult to see when they are fully healed. It may take several months for your scar to fade but eventually it should blend into the natural folds and contours of your face.
What are the possible problems?
Bleeding from your wound is unlikely to be a problem. If it happens it usually does so within the first 12 hours of surgery, which is why you need to stay in hospital overnight.
Infection is uncommon but if your surgeon thinks it is a possibility you will be prescribed a short course of antibiotics.
Sometimes saliva leaks out of your wound (salivary fistula). This problem usually settles down on its own but can take several weeks to get better.
The surgeon tells me that damage to nerves is possible. What does this mean?
The facial nerve runs directly through the centre of the parotid gland. It is the nerve that makes the muscles of your face work. Damage to some or all of that nerve can result in weakness of the muscles on one side of your face. Most nerve damage happens as a result of bruising, since the facial nerve is held out of the way and protected during surgery.
If nerve damage occurs it is usually temporary, although it can take several months to recover fully.
The nerve that supplies feeling to your ear lobe (greater auricular nerve) sometimes needs to be removed to gain access to the parotid gland. As a result you may end up with a numb or tingling feeling in your ear lobe.
Is permanent nerve damage possible?
Although the majority of damage to the nerves is temporary, permanent damage is possible but usually only happens in the most difficult cases.
Are there any long-term effects if I have my parotid gland removed?
The removal of one parotid gland will not affect the amount of saliva that you produce. There are many other salivary glands left in and around your mouth that will still keep it moist.
Some patients notice that the skin in and around their ear sweats a lot after the parotid gland has been removed (gustatory sweating, Frey’s syndrome). The sweating is particularly noticeable around mealtime when the skin can also turn red and feel warm. If this happens it can usually be helped with simple treatments that do not need further surgery.
What if I have any questions or concerns?
If you have any questions or concerns, please speak to the healthcare professional responsible for your care.