Getting Ready for Parotidectomy

How is the surgery done?

• The surgery is done under general anesthesia (completely asleep).
• An incision is made in front of the ear, around the earlobe and into a skin crease in the neck.
• Your surgeon finds the parotid gland and the main trunk of the facial nerve, the nerve that moves your face. The growth and some normal gland around it are freed from the nerve and removed.
• The incision is closed with stitches, and a small drain is placed.

Our salivary gland page explains who the surgery helps.

1. 1Parotid gland
2. 2Facial nerve branches
3. 3Usual incision line
4. 4Ear
5. 5Lower jaw (its angle sits under the gland)

The gland, the nerve and the incision. The facial nerve, which moves the face, branches out through the parotid gland. The incision usually runs in front of the ear, around the earlobe and into a crease in the upper neck.

What are the risks?

Every surgery has risks. Your surgeon will go over them with you before surgery, and you can ask about any of them.

• Anesthesia is safe, but it has some risks. The anesthesia team can go over them with you. Tell us if anyone in your family has had a problem with anesthesia.
• Pain, bleeding and infection are risks of any surgery.
• Facial nerve weakness. The nerve that moves your face runs through the parotid gland and can be injured during surgery. Weakness that goes away with time happens in about 20 to 50 in 100 people, and lasting weakness, of part or all of that side of the face, in about 1 to 5 in 100. The risk is higher when the growth is deep in the gland, when the whole gland is removed, or when the growth is cancer. Facial weakness can cause a droop, drooling, an uneven smile, trouble breathing through the nose and trouble closing the eye fully.
• Numbness around the earlobe is common and may be temporary or permanent.
• A scar in front of the ear and on the neck. It is usually well hidden, but in some people it is more noticeable.
• Frey syndrome: sweating and flushing of the cheek while eating, in about 1 in 10 people.
• Saliva collecting under the skin (sialocele) or leaking through the skin (salivary fistula), in about 1 in 20 people.
• First bite syndrome: a strong cramp in the face with the first bite of each meal. This is rare.

How do I get ready?

• As soon as surgery is scheduled

  • Give us a list of every medicine, vitamin and supplement you take. We will tell you which to stop and when.
  • If you smoke or vape, stop now. Stopping helps your body heal and makes anesthesia safer, and the earlier you stop, the better: aim for at least 4 weeks before surgery, though even 2 weeks helps. Stay off until your surgeon says you have healed.
  • Plan time off. Plan on 1 week off work or school.
  • Plan your travel. For 1 week after surgery, stay within about an hour of our office or an emergency room, and do not fly.
  • Arrange for an adult to drive you home. After general anesthesia, we recommend having an adult stay with you the first night.

• 1 to 2 weeks before

  • Aspirin is usually stopped 1 to 2 weeks before surgery. If you take aspirin or a blood thinner for your heart, a stent or stroke prevention, do not stop it on your own: your surgeon will check with whoever prescribes it.
  • Ask us whether to pause ibuprofen (Advil, Motrin) or naproxen (Aleve).
  • Ask about herbal remedies and supplements, such as fish oil, vitamin E, ginkgo or garlic pills, which can raise the chance of bleeding.
  • If you take insulin or other diabetes medicines, ask how to take them before surgery.
  • Get the supplies in the next section.

• The night before

  • Follow the eating and drinking instructions from our office or the surgery center exactly. If you eat or drink when you should not, surgery may need to be postponed for safety.
  • Many places ask for nothing to eat after midnight, and some allow clear liquids until a few hours before.
  • Take only the medicines we said to take that morning, with a small sip of water.
  • Get a good night’s sleep.

• The day of surgery

  • Wear comfortable clothes.
  • Wear glasses instead of contact lenses, and leave jewelry and valuables at home.
  • Bring your photo ID, insurance card and list of medicines.
  • We will tell you your arrival time before the day of surgery. It is usually about 1 hour before surgery.

What happens after surgery?

• Most people go home the same day.
• You will likely go home with a small drain in the neck. The nurse will show you how to empty it and record the amount. It comes out in our office 2 to 3 days after surgery.
• Most stitches dissolve. If you have stitches that need to come out, we remove them at your first visit.
• Plan on 1 week off work or school. No heavy lifting or strenuous activity for 2 weeks.

The Parotidectomy Recovery Guide has everything you need after the procedure, including when to call us.

When should I call before surgery?