Removal of the parotid salivary gland

This leaflet aims to answer some of the common questions patients have about this treatment. It is not meant to replace the information discussed between you and your doctor. However, it can act as a starting point for such a discussion or as a useful reminder of the key points.

This leaflet explains the following.

• What the parotid gland is.

• What happens during and after the operation.

• What the risks and possible long-term effects are.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.

What is the parotid gland?

What does the operation involve?

• The parotid gland is removed under general anaesthetic (you are asleep for the procedure).

• During the operation, a cut is made in front of your ear. The cut either extends downwards into your neck or behind your ear.

• Once the gland is removed, stitches are used to hold the cut together. The team will advise if and when the stitches need to be removed. Often stitches on the skin surface are dissolvable, and do not need to be removed by a GP or GP nurse.

• At the end of your operation, a small tube is placed through your skin into the wound. This tube is used to drain any blood which may collect. This tube 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 caused by a stone, your surgeon may also need to make a cut inside your mouth to remove the stone. You will discuss this with your surgeon before your operation.

How long will the operation take?

Removal of all or part of the parotid gland is a complicated operation. The operation takes approximately 2 hours.

What happens if I choose not to have surgery?

If you choose not to have surgery, this will be discussed with your surgeon. They may continue to monitor your condition or discharge you back to your GP. Surgery is the only way of removing a lump.

What can I expect after my operation?

• Most patients stay in hospital for 1 night following their surgery.

• You are unlikely to feel very sore, but you will be given regular painkillers after surgery.

• There will be a little swelling following parotid gland removal.

• Since part of the gland has been 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 work, to recover from your surgery. Do not do any strenuous activity during this time.

How do I care for my wound at home?

You must keep your wound dry for the first week following surgery. Take care when washing or shaving.

Will I have a scar?

All cuts made through the skin leave a scar. Most fade with time, and are difficult to see when fully healed.

It may take several months for your scar to fade. Eventually it should blend into the natural folds and contours of your face.

What are the possible complications?

• Bleeding from your wound is unlikely to be a problem. If this happens, it usually does so within the first 12 hours of surgery. This is the reason you need to stay in hospital overnight.

• Infection is uncommon. If your surgeon thinks it is a possibility, they will prescribe you 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.

If you have any concerns or worries, please speak to your surgeon.

My 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, as the facial nerve is held out of the way and protected during surgery.

If nerve damage occurs it is usually temporary. It can take several months to recover fully.

Sometimes the surgeon needs to remove the nerve that supplies feeling to the ear lobe. This nerve is called the greater auricular nerve. It is removed so the surgeon can access 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?

Most damage to the nerves is temporary, but permanent damage is possible. Permanent damage 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 you produce. There are many other salivary glands left in and around your mouth that will keep it moist.

After removal, some patients notice that the skin in and around their ear sweats a lot. This is a condition called gustatory sweating, or Frey’s syndrome. The sweating is more noticeable around mealtimes, 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. For more information, please speak to your GP.

What if I have any questions or concerns?

If you have any questions or concerns, please speak to a member of your healthcare team.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

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• Patient Voice Team
  Telephone: 01227 868605
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