Parotidectomy involves the removal of the part of the parotid gland which contains the lesion. A key part of the surgery is to identify branches of the facial nerve which controls the movement of the facial muscles on the corresponding side of the face.

Parotidectomy requires an overnight stay. You will wake from surgery with a small drain in your neck which is attached to a reservoir. If the drain amount is minimal overnight, you will be discharged the next day. Occasionally you will be required to stay a few days if the drain amount is significant or if you require substantial pain relief.

Most patient will require 1-2 weeks off work.

The main risks of parotid gland surgery are:

• Injury to the Facial Nerve:

Dr Tan-Gore utilises a combination of intra-operative nerve monitoring and magnification loupes to guide her during surgery. Surgery to the parotid gland carries a moderate risk of temporary facial nerve palsy (approximately 20%) but a very low risk of permanent nerve injury (<1%).

• Facial Scarring:

The incision for parotid surgery is placed in the crease in front of your ear and can sometimes extend into the mid-portion of your neck. Dr Tan-Gore is careful to keep most of the incision in natural crease lines to ensure that the scar is minimally visible. However, in patients with a history of keloid scarring, this can be noticeable.

• Saliva Leak (Sialocoele):

Saliva can leak from the cut surface of the parotid gland and this travels to the skin, causing a leak through the incision. The sialocoele usually settles in 2-4 weeks. If this does not settle, treatment to stop the leak ranges from pressure bandaging to injection of botox into the gland.

• Ear Numbness:

The great auricular nerve supplies the earlobe area and may be transected to facilitate exposure of the parotid gland. This results in permanent numbness to the earlobe region.

• Facial Asymmetry:

The parotid gland contributes to the shape of the side of your face (cheek area) and removal of part of the gland can cause flattening of the facial contour.

• Frey’s Syndrome/Gustatory Sweating:

A late complication (months) is the development of a condition where eating causes sweating on the face. This is an unusual complication that sometimes requires further intervention.

During your Consultation with Dr Tan-Gore, you will receive information regarding:

• Your procedure, hospital and date of surgery including expected length of stay

• The reason for your procedure

• The risks of the procedure, as part of the Informed Consent process

• How long your procedure will take

• Any further investigations or tests that are required before surgery

• Your post-operative course, e.g. how much time off work, how long before you can resume exercise

As part of the booking process, Dr Tan-Gore will complete a Booking Form for the Hospital and a Consent Form.

After this, you can choose to complete your Booking Details by either:

1. Completing the form in paper form and submitting it to the hospital, or

2. Online:

•                 Lake Macquarie Private Hospital:  lakemacquarieprivate.com. “Online Admissons”

•                 Lingard Private Hospital: lingardprivate.com.au. “Online Admission Form”

The Hospital will contact you a few days before your surgery date to advise you of your arrival time, fasting time and any other relevant information to help you prepare for your stay.

The Anaesthetist will contact you to assess your fitness for surgery.

The Anaesthetist will advise you of their fees based on the type of surgery you are having.

This process is separate from Dr Tan-Gore’s practice at H+ Consulting Suites.

After your Consultation with Dr Tan-Gore, you will receive a Fee Estimate. This will include an itemised invoice, estimated Rebate and estimated Out-of-Pocket Cost.

Payment of the total amount is required before your procedure date. Once you receive your receipt, you will need to lodge a claim with:

• Medicare: for your Medicare Rebate

• Your Health Fund: For your Health Fund Rebate

Your ‘Out-of-Pocket’ amount is the difference between your ‘Total Amount’ and the Rebates that you receive.

Your Fee Estimate contains only an estimate of your rebate and the actual amount from Medicare and your Health Fund may vary.

Please be advised that there may be adjustments to your Fee Estimate if Dr Tan-Gore determines that it is in your best interests during surgery. She will have advised you of this during the Consent process.

Please be advised that Dental Procedures do not attract a Medicare Rebate, and some Dental Procedure do not attract Health Fund Rebate.

Once you have received your Fee Estimate, Dr Tan-Gore advises that you contact your Health Fund to determine your level of cover.

You will have pain and swelling in the post-operative period. This usually peaks at day 3-5 with a gradual improvement in your symptoms after that.

Pain Relief:

You will be given a script for analgesia. Dr Tan-Gore advises that you take the pain relief on a regular schedule for the first 5-7 days, even if you do not feel like you need it. This will ensure that you remain comfortable and minimise breakthrough pain that may require more significant analgesia. Consider setting a timer to remind yourself.

Diet/Hydration: 

You should be able to eat a normal diet. Some patients may find it more comfortable to have a soft diet for a few days. Ensure that you drink plenty of fluids, even if you do not feel like eating.

Wound Care:

Your wound will be covered by a waterproof dressing (adhesive tape or dermal glue) which allows you to shower and wash your hair. Carefully dry your skin afterwards. Do not immerse your wound in water (e.g. bath or swimming pool) for 1 week.

After the wound has healed, you will be encouraged to massage the wound to help flatten the scar.

Do not expose your wound to the sun. Apply sunscreen with a high SPF when outdoors.

Exercise:  

Gentle exercise is recommended during the first week after your surgery.

Return To Normal Funnction:

Dr Tan-Gore advises for you to return to your normal activities in a sensible gradual approach

You can return to driving provided you have good neck mobility, usually after 5 days.

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