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Facial Nerve Loss due to Surgery for Parotid Cancer

  • Facial Nerve Loss due to Surgery for Parotid Cancer
  • Facial Nerve Loss due to Surgery for Parotid Cancer

Description of Disability:

A parotidectomy is the surgical excision (removal) of the parotid gland, the major and largest of the salivary glands. The procedure is most typically performed due to neoplasms (tumors), which are growths of rapidly and abnormally dividing cells. Neoplasms can be benign (non-cancerous) or malignant (cancerous). The majority of parotid gland tumors are benign, however 20% of parotid tumors are found to be malignant. A parotidectomy is mostly performed by an oral and maxillofacial surgeon and otolaryngologist. Different types and techniques have been developed in order to complete a parotidectomy and consequently, many different names have been associated with each type. However, there are really only two main distinctions to be made in parotidectomies: 

 1. The specific nerve(s) to be dissected or not dissected 

2. The amount of gland excised


It is important to note that the specific surgery chosen is based on preservation of the facial nerve in order to avoid significant morbidities (diseases). Furthermore, there are still many controversies regarding the choice of surgery and incidence of cancer recurrence. Below indicates the various and main techniques typically associated with a 


 • SUPERFICIAL (NEAR SURFACE) OR LATERAL (SIDE) PAROTIDECTOMY - excising all the parts of the gland superficial or lateral to the facial nerve. –partial superficial parotidectomy - superficial parotidectomy where the surgeon excises only the portion of the gland surrounding the neoplasm. Only some nerves of the face are dissected during this procedure. –formal superficial parotidectomy - superficial parotidectomy where the cervicofacial and temporofacial nerves are dissected. 

 • TOTAL PAROTIDECTOMY - total removal of the deep part of the parotid gland. Typically performed if neoplasm is affecting deep part of parotid gland. Surgeon tries to remove the gland apart from the facial nerve, yet dissecting all branches of the facial nerves. This method can be done using the transcervical surgical approach. 

 • RADICAL PAROTIDECTOMY - Typically performed if neoplasm is impinging on facial nerve. Facial nerve excised in addition to parotid gland.

Post operative care: 

Rest, head end elevation and immobilization.


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