The parotid gland is one of the major glands that produce saliva. Removal of all or part of the parotid gland is referred to as parotidectomy, and is usually done for benign or malignant (cancer) tumours of the parotid gland. It is one of the most satisfying surgeries for both patient and surgeon. Although 80% of tumours are benign, they can be unattractive, and there is a small risk that a benign lump can become malignant over many years.
The surgery is done under general anaesthesia. The incision is similar to the one used for facelifts, and heals very well, with a good cosmetic result. Patients remain in hospital for 2 – 3 days for monitoring. The major risk is injury to the facial nerve, but this is uncommon, occurring in less than 1% of cases. Usually the nerve is transiently weak, in up to 20% of cases, but recovers within a week.
Other complications included blood clots, which may necessitate a return to the OR to remove it and stop the source of the bleeding. Facial and ear numbness are common and often unavoidable, as a result of cutting the nerve that supplies these areas. Frey’s syndrome refers to sweating of the skin over the cheek whilst eating. It occurs as a result of the nerves regrowing into the skin after the operation, and is easily treated with antiperspirant roll-ons.
The submandibular gland is the second of the major salivary glands. Indications for its removal include tumours, but also recurrent infections and stones (which rarely occur in the parotid gland).
The surgery is done under general anaesthetic, via an incision in the neck, below the jaw. Patients remain in the hospital for about 2 days afterwards.
The main complications include bleeding and weakness or numbness of the tongue, although these are extremely rare. This is usually transient. Very rarely, weakness of the corner of the mouth or lower lip can result.
Microlaryngoscopy & Oesophagoscopy
In order to examine the voice box, windpipe and food pipe, it is sometimes necessary to perform these procedures, under general anaesthetic. This is usually to aid in the diagnosis of the cause of hoarseness, sore throat or difficulty breathing, or to treat conditions such as vocal cord polyps. The surgeon may perform biopsies of these structures. In addition, treatment of eg vocal polyps, may be undertaken simultaneously.
The procedures are usually very well tolerated, but can result in some throat pain afterwards. Very seldom, teeth can become chipped or dislodged (this usually only happens when the patient’s dental hygiene is poor to start with). Depending on the findings, patients may spend a few days in hospital.
A tracheostomy refers to a surgically created opening in the neck, into the windpipe. It is employed in the treatment of patients with airway obstruction, cancer and certain voice disorders. It is also done for critically ill patients who have had a breathing tube for sometime, to prevent scarring and narrowing of the airway.
Laryngectomy refers to removal of all or part of the larynx, or voice box. This is usually done for cancer, but there are other indications as well. The procedure is complex, and is best discussed with your surgeon.
Following trauma, such as ingestion of acid or caustic substances, or prolonged intubation in ICU with a breathing tube, the windpipe sometimes scars and becomes narrow. The patient then has difficulty breathing and/or voicing.
Several options exist for dealing with this problem, including laser, dilation and tracheal resection. Your surgeon will discuss the best option with you.