42410 Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection

Name of the Procedure:

Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection

Summary

This procedure involves the surgical removal of a tumor or part of the parotid gland, specifically targeting the lateral lobe. Importantly, the surgery is performed without dissecting the facial nerve, which runs through the parotid gland and controls facial movements.

Purpose

The procedure aims to remove benign or malignant tumors from the parotid gland while preserving facial nerve function. This helps to alleviate symptoms, prevent tumor spread, and improve the quality of life.

Indications

• Presence of a mass or tumor in the parotid gland
• Symptoms such as facial swelling, pain, or difficulty in facial movements
• Suspicion of malignancy based on imaging or biopsy
• Recurrent infections or other parotid gland disorders

Preparation

• Fasting for at least 8 hours before the procedure
• Medication adjustments as instructed by the physician (e.g., stopping blood thinners)
• Pre-operative assessments like blood tests, imaging studies (CT or MRI), and possibly fine-needle aspiration biopsy

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free during the surgery.
2. An incision is made near the ear, extending into the neck if necessary.
3. The surgeon carefully dissects through the tissues to access the parotid gland's lateral lobe.
4. The tumor or diseased tissue is excised, avoiding any dissection of the facial nerve.
5. The wound is then closed with sutures, and a drain may be placed to collect any fluids.

Duration

The procedure typically takes 2-4 hours, depending on the complexity and size of the tumor.

Setting

This procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• A head and neck surgeon
• An anesthesiologist
• Surgical nurses
• Possibly a radiologist or pathologist

Risks and Complications

• Bleeding
• Infection
• Temporary or permanent facial weakness or numbness
• Scarring
• Salivary fistula (an abnormal connection to the skin)
• Anesthesia-related risks

Benefits

• Removal of the tumor with minimal risk to facial nerve function
• Relief from symptoms such as pain and swelling
• Prevention of tumor spread or malignancy

Recovery

• Monitoring in a recovery room for a few hours post-surgery
• Hospital stay of 1-2 days may be required
• Pain management with prescribed medications
• Care instructions for the incision site, including keeping it clean and dry
• Follow-up appointments for wound check and stitch removal

Alternatives

• Observation and regular monitoring for small, asymptomatic tumors
• Radiation therapy or chemotherapy for malignant tumors
• Other surgical methods that may involve nerve dissection, with different risk profiles

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Post-procedure, they may experience some pain and swelling at the incision site, which can be managed with medications. Recovery includes some days of rest, avoiding strenuous activities, and adhering to follow-up care recommendations.