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Types of Parotid Surgery

Patients should have a thorough discussion with their surgeon about the type of parotid surgery that will be performed, so the patient knows what to expect during surgery and recovery.

Superficial Parotidectomy
This surgery involves the removal of the portion of the parotid gland that lies above the facial nerve (superficial lobe) and preserves the facial nerve. This is the standard operation for tumors that are located in the superficial lobe of the parotid gland.

Partial Superficial Parotidectomy
This surgery involves the removal of the tumor in the superficial lobe, and a small portion of healthy gland tissue surrounding the tumor to prevent the tumor from growing back but does not remove the entire superficial lobe.

Deep Lobe Parotidectomy
This surgery involves the removal of the portion of the parotid gland that lies underneath the facial nerve (deep lobe). The portion of the gland that lies above the facial nerve (superficial lobe) will be moved during surgery to allow the surgeon to identify the branches of the facial nerve, but it will not be removed if the tumor does not involve the superficial lobe.

Total Parotidectomy
This surgery involves the removal of the entire parotid gland. Generally, this surgical technique will be used when a patient has a malignant tumor that has spread or has the potential to spread to the parotid lymph nodes. A patient will often need reconstruction to fill in the defect left behind by the total removal of the parotid gland.

Total Parotidectomy with Facial Nerve Resection and Repair
This surgery is performed when a patient has a malignant parotid tumor that involves parts, or all of the facial nerve.  A partial or complete facial nerve resection will be performed, and this surgery often involves facial nerve and parotid bed reconstruction.

Extended Total Parotidectomy
This surgery involves the removal of the entire parotid gland and may involve the removal of surrounding structures. The decision to remove surrounding structures will be based on tumor growth and behavior.

Neck Dissection
This procedure will be done during parotid surgery to remove lymph nodes from the neck when the surgeon has evidence that a malignant tumor has spread to the lymph nodes of the neck.

Click here to learn more about this topic in our podcast series, Parotid Tumor Podcast.

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. 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.