Specialist Surgery for Parotid Gland Tumours
Parotid gland tumours arise within the largest of the salivary glands, located just in front of and below the ear.
Surgical removal is the primary treatment for most parotid tumours. The procedure requires careful planning due to the presence of the facial nerve, which runs through the gland and controls facial movement.
The aim is to remove the tumour safely while preserving nerve function and achieving a balanced cosmetic outcome.
Understanding Parotid Tumours
Parotid tumours may be:
- Benign (most common, e.g. pleomorphic adenoma, Warthin’s tumour)
- Malignant (less common, but require more extensive treatment)
Even benign tumours are usually removed, as they can:
- Continue to grow over time
- Become more complex to treat
- Occasionally undergo change
The Role of Surgery
Surgery is planned to:
- Completely remove the tumour
- Preserve the facial nerve and its branches
- Minimise the risk of recurrence
- Achieve a well-healed, discreet scar
The exact technique depends on the size, location, and nature of the tumour.
Surgical Techniques
Partial Parotidectomy
- Removes the part of the gland containing the tumour
- Involves careful identification and protection of the facial nerve
- Provides a reliable and oncologically sound approach
Extracapsular Dissection
- Removes the tumour with a cuff of surrounding tissue
- Avoids routine exposure of the main facial nerve trunk
- Less invasive, with reduced tissue disruption
Used selectively for small, well-defined benign tumours in favourable locations.
Facelift Approach
- Incision placed around the ear and into the hairline
- Avoids a visible neck scar
- Provides a more discreet cosmetic outcome
This relates to the incision design rather than the extent of gland removal.
Facial Nerve Preservation and Monitoring
The facial nerve is central to parotid surgery, controlling movement of the face.
During surgery:
- The nerve and its branches are carefully identified and preserved
- Intraoperative facial nerve monitoring is used to assist this process
Facial nerve monitoring works by:
- Providing real-time feedback on nerve function
- Helping identify nerve branches during dissection
- Reducing the risk of inadvertent injury
This adds an additional level of safety, particularly in:
- More complex tumours
- Revision surgery
- Cases where anatomy is distorted
In the majority of cases, normal facial movement is preserved. Temporary weakness can occur and usually improves over time.
Recovery
Recovery depends on the extent of surgery.
- A short hospital stay may be required
- A surgical drain may present for the first few days
- Swelling and bruising settle over several weeks
- Sutures are typically removed within 1–2 weeks
- Return to normal activity is gradual
Follow-up ensures appropriate healing and functional recovery.
Risks and Considerations
Potential risks include:
- Temporary or, rarely, permanent facial nerve weakness
- Numbness around the ear
- Bleeding or infection (uncommon)
- Salivary leak or fluid collection
- Frey’s syndrome (sweating when eating)
- Recurrence depending on tumour type
Careful planning, technique, and nerve monitoring help minimise these risks.
Consultation
A detailed consultation includes assessment of the lump, imaging where required, and discussion of the most appropriate surgical approach.
Book a Consultation
For assessment and treatment of parotid gland tumours in London, arrange a consultation to discuss your case in detail.