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Parotid Gland Surgery

Bardhaman Maxillofacial Clinic: Your Trusted Partner in Parotid Gland Surgery.
The parotid gland is the largest of the salivary glands, located near the mandible and anterior to the ear. It plays a crucial role in the digestive system by producing saliva, which aids in the initial digestion of food, maintaining oral health, and facilitating speech.
Location:
The parotid glands are situated bilaterally, anterior and below the ear and extending to the angle of the mandible.
Structure:
The gland is encapsulated by a fibrous tissue capsule and is divided into superficial and deep lobes.
Superficial Lobe: Lies just beneath the skin.
Deep Lobe: Extends posteriorly and medially, surrounding the facial nerve branches (CN VII).
Ducts: The parotid duct (Stensen's duct) extends from the gland, traversing the masseter muscle and opening into the oral cavity opposite the second upper molar.
Physiology
The parotid gland is responsible for producing and secreting saliva, which plays a vital role in digestion and oral health. Saliva contains:
- Enzymes: Such as amylase, which initiates the breakdown of carbohydrates.
- Mucins: Provide lubrication and protect oral structures.
Types of Tumors
Parotid gland tumors are classified into benign and malignant categories.
Benign Tumors
- Pleomorphic Adenoma: The most common benign tumor, also known as a benign mixed tumor, consisting of epithelial and mesenchymal elements.
- Warthin’s Tumor: A cystic tumor strongly associated with smoking, characterized by a mixture of epithelial and lymphoid tissue.
Malignant Tumors
- Mucoepidermoid Carcinoma: The most common malignant tumor, composed of mucous and epidermoid cells.
- Adenoid Cystic Carcinoma: Noted for slow growth and a tendency to invade surrounding tissues.
- Acinic Cell Carcinoma: Arises from serous acinar cells of the gland.
- Salivary Duct Carcinoma: A high-grade malignancy resembling ductal carcinoma of the breast.
Treatment
Benign Tumors
Superficial Parotidectomy is the standard treatment for benign tumors.
Malignant Tumors
Treatment varies based on the tumor type and stage and may include:
- Surgery: Total Parotidectomy, often including removal of surrounding tissue and lymph nodes (Neck Dissection).
- Radiation Therapy: Used as an adjunct to surgery, especially for high-grade tumors.
- Chemotherapy: Considered in advanced or metastatic cases.
Follow-Up and Monitoring
Regular follow-ups are essential to monitor for tumor recurrence, particularly in malignant cases.
Complications
Possible complications related to parotid gland tumors and their treatment include:
- Facial Nerve Injury: Risk of nerve damage during surgery, potentially causing facial weakness or paralysis.
- Salivary Fistula: Abnormal connections causing saliva leakage post-surgery.
- Infection: Risk of postoperative infections.
- Recurrence: Benign tumors may recur if not completely removed, while malignant tumors have a higher risk of metastasis.
- Xerostomia: Dry mouth due to reduced saliva production, particularly after radiation therapy.
Conclusion
The parotid gland plays a crucial role in oral health and digestion. Understanding its anatomy and physiology is essential for diagnosing and treating tumors effectively. Awareness of potential complications ensures comprehensive care for patients. Regular follow-ups are critical for managing both short- and long-term outcomes in affected individuals.
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If the cavity isn’t repaired, this cavity will continue to expand—eventually entering into your nerve canal. This can be excruciatingly painful. However, it can also lead to dire problems such as abscess or infection. Replacing old fillings or fixing chipped teeth can also be required. The most important reason to fix your cavity early on is to avoid a painful and costly root canal.
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