A parotidectomy is a major surgical procedure to treat cancer of the parotid gland. Using a case study approach, Emily Humphrey provides an enhanced understanding that will help the scrub practitioner anticipate surgical needs, provide instruments in a timely manner, and improve intraoperative communication between the scrub and the surgical team.
A parotidectomy removes part of or all the parotid gland, a major salivary gland in the human body. The purpose of this article is to support the knowledge and understanding of scrub practitioners about local anatomy and clinical issues relevant to performing a parotidectomy, in particular the pathway a surgical technique might look like. This is lengthy and potentially risky surgery given the nerves and vessels in the vicinity of the parotid gland and, as will be discussed, there is a considerable amount of individual variation in the anatomical layout of the facial nerve and its branches.1 In light of this, it is hoped that this article will inspire confidence in practitioners to assist in this fascinating, if at times daunting, procedure.
Why are parotidectomies performed?
The parotidectomy procedure is commonly performed to remove neoplasms or tumours which are growths of rapidly and abnormally dividing cells. The parotid gland is the most frequent of the salivary glands to develop tumours, although 80% of parotid gland tumours are benign.2 In fact, malignant tumours are more likely to occur in the submandibular and minor salivary glands.3 Malignancy in the parotid gland can also commonly be due to lymph node metastases (spread) from a skin cancer in the head and neck region such as a cutaneous squamous cell carcinoma or a malignant melanoma, rather than being due to a primary malignant tumour arising in the gland.4,5
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