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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
- Anesthesia: General anesthesia is typically administered.
- Incision: A surgical incision is made near the ear.
- Dissection: The surgeon carefully dissects the tissue to expose the parotid gland and locate the facial nerve.
- Tumor Removal: The tumor is excised from the lateral lobe of the parotid gland.
- Nerve Preservation: Special attention is given to preserve the facial nerve.
- 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.