The parotid gland is a key pathway for the facial nerve and can have a significant role in facial nerve disorders.
What is the Parotid Gland?
The parotid gland is an important salivary gland in the body because it is a key pathway for the facial nerve. It also can have a significant role in facial nerve disorders.
The parotid gland pumps saliva through the Stensen’s duct, into the mouth, which helps keep the mouth wet and alleviates swallowing problems. Infections, trauma and tumors can potentially cause facial nerve problems.
What Causes Parotid Gland Problems?
The most common causes of facial nerve disorders as a result of the parotid gland is tumors (pleomorphic adenoma), malignancy (adenoid cystic carcinoma, adenocarcinoma), trauma, and infectious process. Even though the mumps have all been eliminated with routine vaccinations, this viral infection will give you an idea of how serious an infection of the Parotid gland can be.
Parotid tumors are typically benign and can be treated with surgery. The most common parotid tumor is pleomorphic adenoma which usually presents with a pain-less lump at the jaw line in front of the ear. Other tumors are typically more concerning and can be malignant such as adenoid cystic carcinoma, adenocarcinoma, and squamous cell carcinoma.
Staphylococcus (Staph infections) aureus is the most common reason the Parotid gland becomes infected and usually if can be contained with antibiotics and anti-inflammatories. Bacteria that create tuberculosis are another factor that can cause Parotid infections. Another bacteria, which causes “Acute suppurative parotitis” is also a painful and similar infection. These can usually be treated by drugs.
Diabetes, bulimia and alcoholism may cause enlarged parotid glands but usually these are not painful and there is a small group of AIDS victims that have experienced parotitis.
Any blockage to the parotid duct such as a tumor, mucous plug, salivary stone is usually the cause of painful and deadly parotiditis. Calcium is what forms salivary stones. Usually they can be detected by X-ray about 80% of the time.
Chronic inflammation of the parotid gland may be caused by Sjogren’s syndrome. This is caused by an autoimmune disease and can be a serious problem. There is no known cause for Sjogren’s syndrome at this time. Dryness in the eyes, nose, skin and mouth in the facial area along with swelling is an indication of Sjogren’s syndrome.
Where is the Parotid Gland Located?
The parotid gland sits under the skin, and wraps around the back of the jaw at the mandibular ramus. The gland sits in an area which is anterior to the ear. This gland is palpated bilaterally and there is one on each side of the head behind the ear. The facial nerve, although it does not control the gland, it runs through it.
Before and After Parotidectomy Treatment
Partoid Gland Removal Treatment
At The Facial Paralysis Institute, Dr. Azizzadeh and Dr. Larian use a multi-specialty approach to address parotid tumors. Dr. Larian is a renowned head and neck surgeon and the director of the Cedars-Sinai Head and Neck Cancer Center. He uses a minimally invasive and cutting-edge technique to safely remove the tumor with the highest rate of facial nerve preservation. Dr. Azizzadeh, a facial plastic and reconstructive surgeon, helps to plan the surgical incision and reconstruction of the region so that a scar-free and dent-free results can be obtained. Furthermore, given Dr. Azizzadeh’s facial nerve expertise, the rate of facial nerve preservation and outcome is safely guarded.
How Do Dr. Larian and Dr. Azizzadeh Approach Parotidectomy Treatments?
Parotidectomy is a team effort between Dr. Larian and Dr. Azizzadeh. Dr. Larian is a head and neck surgeon who does the parotid removal surgery. Meanwhile, Dr. Azizzadeh is also present during the parotidectomy to track the facial nerve while Dr. Larian is removing the parotid tumor.
The facial nerve can be found in different places and because they are so small they do not show up on any pre-operative scans. In most cases, the tumor will be superficial to the facial nerve (or on top of the nerve). In some cases, the facial nerve may be located in the middle of tumor. As such, it is important for Dr. Azizzadeh to be there to track the facial nerve during a parotidectomy. By tracking the facial nerve, Dr. Azizzadeh ensures the facial nerve is preserved and the patient can wake up with a smile.
What to Expect During a Parotidectomy
During a parotidectomy, Dr. Larian remove a portion of the parotid gland via a small and well-hidden incision near the ear. This minimally invasive approach enables Dr. Larian to reduce pain and scarring and ensure a patient can speed up his or her recovery. At the same time, Dr. Azizzadeh monitors the facial nerve.
After the parotid tumor has been located and removed by Dr. Larian, Dr. Azizzadeh performs a reconstructive procedure to fill in the defect left behind by the removal of the parotid tumor and surrounding parotid gland. This corrective procedure helps restore symmetry to the face and adds a layer of protective tissue on top of the facial nerve, thereby reducing the risk of Frey’s syndrome (a neurological disorder that causes sweating and flushing of a patch of skin near the ear). Dr. Azizzadeh will use muscle flaps, grafts or a combination of the two to provide a positive aesthetic outcome and ensure a patient experiences little to no scarring.
A parotidectomy is generally performed as an outpatient procedure. Most parotidectomy patients do not require hospitalization, and they usually can return home the same day as surgery.
Schedule a Parotidectomy Consultation with the Facial Paralysis Institute Today
A parotidectomy is a safe, effective procedure that has been shown to help patients address a wide range of parotid gland problems. With support from Dr. Larian and Dr. Azizzadeh, patients can undergo a parotidectomy to alleviate assorted parotid gland problems both now and in the future. Please call us anytime for a free consultation on how we may be able to treat your condition. The Facial Paralysis Institute is one of the most advanced centers of its kind in the world dealing with such problems.
If you are actively considering parotidectomy, schedule a consultation with Beverly Hills facial paralysis expert Dr. Azizzadeh by calling (310) 657-2203 today!
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