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Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve

CPT4 code

Name of the Procedure:

Excision of Parotid Tumor or Parotid Gland: Lateral Lobe, with Dissection and Preservation of Facial Nerve

Summary

In this procedure, the surgeon removes a tumor from the lateral lobe of the parotid gland, which is the salivary gland near the ear. The surgeon carefully preserves the facial nerve to prevent facial muscle paralysis.

Purpose

  • Medical Condition: This procedure addresses parotid gland tumors, both benign and malignant.
  • Goals: The primary goal is to remove the tumor while maintaining the functionality of the facial nerve. This helps in preventing facial drooping or loss of facial movements.

Indications

  • Presence of a tumor in the parotid gland.
  • Swelling or lumps near the ear or cheek area.
  • Facial pain or discomfort.
  • Recent changes in facial symmetry or muscle control.

Preparation

  • Fasting: Usually, the patient must fast for about 8 hours before the procedure.
  • Medications: Adjustments to blood-thinning medications may be necessary.
  • Diagnostic Tests: Imaging studies like MRI or CT scans, and a fine needle aspiration biopsy might be conducted.

Procedure Description

  1. Anesthesia: General anesthesia is typically administered.
  2. Incision: A surgical incision is made near the ear.
  3. Dissection: The surgeon carefully dissects the tissue to expose the parotid gland and locate the facial nerve.
  4. Tumor Removal: The tumor is excised from the lateral lobe of the parotid gland.
  5. Nerve Preservation: Special attention is given to preserve the facial nerve.
  6. Closure: The incision is closed with sutures or staples.

Duration

The procedure usually takes about 3 to 4 hours, depending on the complexity.

Setting

The surgery is performed in a hospital or surgical center operating room.

Personnel

  • Surgeons: Specialized in head and neck surgery.
  • Anesthesiologists: Manage anesthesia and patient sedation.
  • Nursing Staff: Assist during surgery and provide post-operative care.

Risks and Complications

  • Common: Temporary facial weakness, swelling, discomfort.
  • Rare: Permanent facial nerve damage, infection, bleeding, hematoma.

Benefits

  • Primary Benefit: Removal of the tumor with preservation of facial nerve function.
  • Timeline: Most patients can see a reduction in symptoms and improvement in facial muscle function within a few weeks.

Recovery

  • Post-Procedure Care: Pain management with medications, care for the surgical site, follow-up visits.
  • Recovery Time: About 2 to 6 weeks for full recovery. Patients may need to avoid strenuous activities during this period.

Alternatives

  • Watchful Waiting: Suitable for small, benign tumors.
  • Radiation Therapy: Used for treating malignant tumors or when surgery is not an option.
  • Cons: Each alternative has specific risks, benefits, and limitations compared to surgical excision.

Patient Experience

During the procedure, the patient will be under general anesthesia and won't feel any pain. Post-procedure experiences may include mild to moderate pain, swelling, and temporary facial weakness, which can be managed with medications and proper care.

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