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What Is Parotidectomy?

Parotidectomy is surgery that removes part or all of the parotid salivary gland, which lies in front of and below the ear. The facial nerve passes through the gland and is a central anatomical consideration during the operation. A superficial parotidectomy removes tissue mainly lateral to the facial nerve, while a total parotidectomy removes both superficial and deep portions of the gland. The extent of surgery depends on tumor location, pathology, size, and whether surrounding structures are involved.

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What Is Parotidectomy?

Parotidectomy is surgery that removes part or all of the parotid salivary gland, which lies in front of and below the ear. The facial nerve passes through the gland and is a central anatomical consideration during the operation. A superficial parotidectomy removes tissue mainly lateral to the facial nerve, while a total parotidectomy removes both superficial and deep portions of the gland. The extent of surgery depends on tumor location, pathology, size, and whether surrounding structures are involved.

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Why Is Parotidectomy Performed?

The procedure is used to remove benign parotid tumors, malignant salivary-gland tumors, and selected recurrent or inflammatory lesions that require surgery. Most parotid tumors are benign, but enlarging masses commonly require diagnostic evaluation because treatment differs by tumor type. Cancer surgery can require total parotidectomy, lymph-node surgery, or removal of involved facial-nerve branches when necessary for complete tumor clearance. Surgeons preserve the facial nerve whenever it is not directly involved and preservation is oncologically safe.

How Is Parotidectomy Performed?

The surgeon makes an incision in front of and around the ear that commonly extends into a natural neck crease. The facial nerve or its major branches are identified, and the gland is carefully separated from the nerve according to the planned superficial or total resection. Tumor tissue is removed without deliberately opening its capsule when possible, and involved adjacent structures are treated according to oncologic requirements. A drain can be placed before closure, and reconstructive tissue can be used to fill the surgical defect or reduce contour changes in selected cases.

What Is Recovery Like After Parotidectomy?

Patients are monitored for bleeding, swelling, facial movement, saliva leakage, pain, and wound healing after surgery. Temporary facial weakness can occur from nerve manipulation even when the nerve remains anatomically intact. Numbness around the earlobe is common because sensory branches near the gland can be divided during the approach. Additional radiation therapy or neck treatment can be recommended after malignant tumor removal depending on pathology, margins, nerve involvement, and lymph-node findings.

What Are the Risks and Complications?

Possible complications include bleeding, infection, salivary fistula, fluid collection, facial weakness, numbness, contour depression, and painful scarring. Facial nerve injury can cause temporary or permanent weakness of part or all of one side of the face. Frey syndrome can develop when regenerating nerve fibers cause sweating or flushing over the cheek during eating. First-bite pain, recurrent tumor, wound problems, or cosmetic asymmetry can also occur and can require additional treatment.

Frequently Asked Questions About Parotidectomy

What is the difference between superficial and total parotidectomy?

Superficial parotidectomy removes gland tissue mainly lateral to the facial nerve, while total parotidectomy removes both the superficial and deep portions of the gland.

Is the facial nerve removed during parotidectomy?

It is usually preserved when it is not involved by tumor. Cancer that directly invades the nerve can require removal of an affected branch or larger nerve segment.

What is Frey syndrome after parotidectomy?

Frey syndrome causes sweating, warmth, or flushing over the surgical area during eating as regenerating nerve fibers connect abnormally with sweat glands in the skin.

Can facial weakness improve after parotidectomy?

Yes. Temporary weakness from nerve manipulation or swelling can improve over weeks to months, while weakness from permanent nerve injury can persist.

References

Parotidectomy. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK557651/. Date Accessed August 13, 2026.

Parotidectomy: Procedure & Recovery. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/24057-parotidectomy-parotid-gland-tumor-surgery. Date Accessed August 13, 2026.

Salivary Gland Cancer Treatment (PDQ?) ? Health Professional Version. National Cancer Institute. https://www.cancer.gov/types/head-and-neck/hp/adult/salivary-gland-treatment-pdq. Date Accessed August 13, 2026.

Treatment of complications of parotid gland surgery. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC2639867/. Date Accessed August 13, 2026.

Frey's Syndrome: What It Is, Causes, Symptoms & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/25185-freys-syndrome. Date Accessed August 13, 2026.