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Types of Incisions

The vast majority of parotid tumors are removed by using an external incision. The goal for the surgeon is to find an incision type that provides adequate exposure to the operative field, and one that will cause the fewest complications for the patient.

The size and location of your tumor will determine the type of incision that is used during your surgery. It is very rare for a surgeon to remove a parotid tumor through the mouth because that technique does not provide the surgeon with good visualization of the facial nerve.

Factors considered when deciding on the best type of incision:

  • Type of tumor
     
  • Size of the tumor
     
  • Location of the tumor
     
  • Adherence of the tumor to the surrounding tissues
     
  • Level of difficulty in the dissection and removal of the tumor

It is vital that the patient and surgeon have a thorough conversation about the type of incision that will be used during surgery to make sure that the surgeon’s, and patient’s expectations are aligned and to ensure that the patient has realistic expectations of what their face will look like after surgery.

When deciding on an incision type, it is crucial that patients keep in mind that the most important part of surgery is ensuring that the tumor, whether benign or malignant, is completely removed to avoid any recurrences or complications in the future.

Patients need to be vigilant and understand that if an incision is kept too small, it could lead to incomplete removal, tumor spillage, greater risk to your facial nerve, and the inability of the surgeon to actually perform the necessary surgery. The majority of parotid incisions can be done in a cosmetically pleasing way and heal very well.

It is important that patients do not compromise their health or safety for the sake of having a small incision. Patients should talk to their surgeon about this - be smart - and don’t hesitate to seek another opinion, if needed. A patient’s final appearance is important but not to the detriment of a safe and complete tumor removal with good long-term results.

Refer to the other pages in this section for more detailed information about incisions.

References

1. Moore, EJ and Olsen, KD (2007). Total Parotidectomy. In KD Olsen, Salivary Gland Disease and Treatment (pp. 214-233). Rochester, MN: Mayo Clinic Department of Otolaryngology, Head and Neck Surgery.

2. Olsen, KD (2004). Superficial Parotidectomy. In KD Olsen, Salivary Gland Disease and Treatment (pp. 234-246). Rochester, MN: Mayo Clinic Department of Otolaryngology, Head and Neck Surgery.

3. Mayo Clinic. (2018, October 8.) Mayo Clinic Parotid Tumor Guide: Parotid Tumor Surgery [Video File]. Retrieved by https://youtu.be/CD60VJxATek

4. The content in this section was drafted in consultation with Eric J. Moore, M.D., and Kerry D. Olsen, M.D., of the Mayo Clinic in Rochester, MN.