When the parotid gland becomes enlarged due to a tumor, whether benign or cancerous, often surgical removal is the best treatment option. In the past, parotid surgery was fraught with risks due to the close proximity of the facial nerve to the parotid gland. The closeness of the facial nerve meant that facial paralysis was a very real risk that people took when having a parotid tumor removed.
Nowadays, with advances in technology and surgical techniques, while the risk is still there, it has been significantly reduced in the hands of expert surgeons. Dr. Larian is one of the foremost parotid surgery experts, and with his experience and expertise, parotid surgery is as safe and effective as it can be.
About Minimally Invasive Parotidectomy
The surgical procedure of choice used to remove a parotid gland is known as a minimally invasive or micro-parotidectomy. This procedure is extremely advanced, using the latest technology in order to remove a parotid tumor without damaging the facial nerve. Dr. Larian is a pioneer in minimally invasive parotid surgery, and has an extremely high success rate.
Superficial parotidectomy, in which only the lobe of the gland closest to the facial nerve is removed, is sometimes an option as it lessens the risk to surrounding facial nerve branches. Dr. Larian will always take the utmost care in formulating a treatment plan for his patients so that they never undergo an unnecessary procedure and will always have the highest possible chances for success and little to no complications in the future.
An EMG facial nerve monitoring device is used in every case to help during the surgery. Every safety measure and precaution is taken before, during and after surgery to assure the facial nerve functions perfectly. Thus the incidence of permanent facial nerve paralysis when removing benign parotid tumors is extremely small (less than 0.1%).
Benefits of Minimally Invasive Parotidectomy
Minimally invasive parotidectomy has a number of benefits, including:
Faster recovery time
Less blood loss and risk of infection
Minimally invasive parotidectomy is an outpatient procedure, and most patients go home the same day. Because the incision is so small, less blood loss occurs and there is less of a risk of infection and complication. Plus, Dr. Larian brings in facial anatomy and reconstruction expert Dr. Azizzadeh during minimally invasive parotidectomy procedures, in order to significantly lower the risk of damaging the delicate facial nerve during surgery.
Team Approach Provides Best Parotidectomy Results
A team approach together with Dr. Babak Azizzadeh, a renowned facial plastics and reconstructive surgeon, is used in order the achieve the best possible results. A face-lift incision that is well hidden in the hairline or a shorter incision just next to the ear is used in most cases, reducing the amount of scarring generally associated with parotidectomy.
Once the parotidectomy is completed, the reconstruction is immediately performed. There are several reconstruction options, but most commonly a portion of the neck muscle called the sternocloidomastoid muscle (SCM) is used. This muscle is rotated into the area of the defect and spread widely to cover the facial nerve. This serves a double purpose: it protects and separates the facial nerve from the overlying skin, preventing potential complications, and it also prevents a depression from occurring on the side of the face.
Adjustments to the excess skin, created by stretching caused by the tumor, are also made at the same time. Dr. Azizzadeh uses an intricate technique to close the incision in order to ensure minimal scarring. This collaborative effort ensures ideal results with a face that looks perfectly even.
Parotidectomy for Cancerous Parotid Tumors
In cases when parotidectomy is performed for a cancer, the location of the tumor dictates how much of the parotid is removed and the risk to the facial nerve. While every effort will always be made to save the facial nerve, cancerous tumors may be too close to the nerve for a clean separation. However, Dr. Larian and Dr. Azizzadeh will always do whatever they can to preserve as much facial movement as possible.
Cancerous parotid tumors are rare, but not unheard of. It is vital to get any lump or swelling near the ear looked at immediately by an expert, as catching tumors as early as possible greatly improves the chances of successful removal. Cancerous parotid tumors can spread quickly to other parts of the body, and the farther along it is, the harder it will be to remove completely.
“I cannot say enough good things about Dr. Larian. By the time my search for a surgeon led me to him, nearly five years had passed since the discovery of a benign tumor in my parotid gland. By then, the tumor had engulfed nearly the entire lower right side of my face. Because of the location of the tumor, even when it was small, removal was considered to pose a significant risk of facial paralysis. My fear of such an outcome kept me looking for a surgeon that I felt confident could remove the tumor with the least amount of damage to my facial nerve. From my initial contact with Dr. Larian and his staff I knew I had come to the right place. I felt like I was being welcomed into a family–a family of world-class experts in the arts of medical care and emotional care. It was truly an astounding experience. There is no paralysis or weakness in my face. There was none immediately post-operatively and there is none now, more seventeen months after the procedure. I had to travel across the country for the surgery, but it was worth it. I would do it again, without hesitation.”
Schedule a Minimal Scar Parotidectomy Consultation With Dr. Larian Today
To learn more about a minimal scar parotidectomy, call our office at 310.461.0300!
Next, read more about the parotid gland.