Living with Parotid Tumour

The parotid is a soft gland, which is poorly palpable under normal conditions. When removed, an empty, hollow area is left between the jaw and the sternocleidomastoid muscle (a large, easy-to-palpate muscle in the anterior, lateral part of the neck) which can be quite evident. Also, the surgery incision leaves a visible scar on the neck. 

Loss of skin sensitivity. This is an inevitable consequence of parotid surgery because the distal branches of the nerve, responsible for controlling the muscles for smiling, frowning and making facial gestures, must be sectioned to gain access to the parotid gland. This causes numbness in the lower part of the ear, similar to when a local anaesthetic is given. However, the mobility of the face is not altered because this depends on the facial nerve; the intention is not to lose its functionality in surgeries where its removal is not necessary. This feeling decreases over time, without it disappearing completely. Sometimes, depending on the anatomy of the nerve, a branch of the nerve may be preserved to maintain the sensitivity of the ear. 

Frey syndrome, gustatory sweating or auriculotemporal syndrome. This is a relatively common complication (20-60%) that usually appears months or even a year after removal (parotidectomy). The syndrome consists of redness or sweating in the part just in front of the ear when salivation is stimulated; that is, when the patient eats, observes or thinks about food. This occurs because, when the brain issues the order for the parotid gland to produce saliva, as it does not have the gland, this signal reaches the sweat glands in the skin. 

In these cases, an intradermal injection of botulinum toxin is an effective method to control the symptoms of sweating and redness. 

Sialocele and seroma. These are cysts composed of saliva (sialocele) or serum (seroma) that accumulate under the skin during the immediate postoperative period as a soft, painless mass. Treatment consists of evacuating the fluid via a puncture and then applying a compression bandage.

Salivary fistula. This consists of the release of saliva through the wound in the immediate postoperative period. It is a rare complication that appears in around 3% of patients with the removal of part of the parotid gland; in most cases, it disappears within a few weeks.

Neuroma of the greater auricular nerve. When the auricular nerve (located behind the ear) grows abnormally, it forms a mass or lump (neuroma) that is painful to the touch. The treatment in this case consists of removing the neuroma; this rules out the recurrence of the original tumour at the same time. 

Secondary facial paralysis in facial nerve injury. This is the most significant complication that can occur in parotid gland surgery. In these cases, the experience of the surgical specialist is essential to remove the parotid gland, due to the complexity of having to identify and preserve all branches of the facial nerve to prevent paralysis.