Parotid tumour and parotidectomy

A lump in front of the ear or at the angle of the jaw can be the sign of a tumour of the parotid, the largest salivary gland. Most of these tumours are benign, but their surgery remains delicate because the facial nerve, which controls facial expression, runs through the gland.

Dr Afshin Yousefpour has unique expertise in Belgium in the management of parotid tumours. He combines two skills: removing the tumour safely, thanks to his in-depth knowledge of the parotid and the facial nerve, and reconstructing the defect left by the excision to preserve the contour of the face.

The protocol, step by step.

1. Step 1

   Advanced imaging

   MRI or ultrasound to define the tumour and determine its position in the gland and in relation to the facial nerve.

2. Step 2

   Tumour analysis

   Fine-needle aspiration when needed, to tailor the operation to the type of tumour.

3. Step 3

   Parotidectomy

   Removal of the tumour through a facelift-type incision, with identification and preservation of the facial nerve branches under monitoring and optical magnification.

4. Step 4

   Reconstruction and follow-up

   Filling of the parotid defect, analysis of the specimen and follow-up of healing.

Why see Dr Yousefpour for a parotid tumour?

Parotidectomy is one of Dr Yousefpour’s major areas of expertise. His long experience of this operation was gained in particular in the head and neck oncology and reconstruction teams he led in the United Kingdom.

His approach brings together, in one surgeon, three skills: dissection of the facial nerve, reconstruction of the parotid defect and the techniques of facial aesthetic surgery.

Parotid tumours

• Indications: benign parotid tumours (pleomorphic adenoma, Warthin’s tumour / cystadenolymphoma), malignant tumours, chronic sialadenitis or parotid cysts.

• Pleomorphic adenoma: the most common benign tumour of the parotid, which grows slowly and can become large.

• Malignant tumours: rarer, they require tailored management, decided after a full assessment.

Removing the tumour safely: parotidectomy

The operation removes part of the gland (superficial or partial parotidectomy) or the whole gland, depending on the extent and nature of the lesion. Removing a parotid tumour means first separating it from the facial nerve, identifying each branch in order to protect it.

• Dr Yousefpour’s particular expertise: continuous facial nerve monitoring (NIM neuromonitoring) combined with magnification under surgical loupes to identify, dissect and preserve each motor nerve branch individually. A facelift-type incision (modified Redon or peri-auricular incision) hides the scar in natural creases and the hairline, combined with filling of the gland defect to avoid a post-operative hollow of the cheek.

• Recovery: moderate swelling of the parotid area for 1 to 2 weeks; a suction drain is common and is removed after 24 to 48 hours; numbness of the earlobe is common and temporary, for a few months; back to usual activities after 10 to 14 days.

• Possible complications: temporary facial weakness due to the delicate handling of the nerve (spontaneous recovery in the vast majority of cases within a few weeks to a few months), localised haematoma or seroma, temporary salivary fistula, Frey’s syndrome (sweating of the skin when chewing, rare and treatable).

Reconstructing the parotid defect: an essential step

After excision, the space left by the tumour and the gland can hollow the cheek in front of the ear. For Dr Yousefpour, reconstruction of this defect is an integral part of the operation, given the same attention as the removal of the tumour.

Trained in head and neck reconstructive surgery, he fills this loss of volume, in particular with nearby muscle flaps, to avoid a hollow cheek and restore the contour of the face. His practice of face and neck lifts also allows him to use an incision hidden in front of and behind the ear and in the hairline, for more discreet healing and a more harmonious result.

Information and consent

At the consultation, your imaging, the operation, the recovery and the risks are explained clearly. You receive an information and consent document, with time to reflect before any decision.

Frequently asked questions