Possible complications that may occur during or after parotid surgery can include injury to the facial nerve. This is the motor nerve that is responsible for movement of facial muscles on that side of the face. Permanent injuries of this kind are very rare, however, the nerve certainly can be stretched during the surgery, and a temporary weakness of some of the branches may occur from time to time. There may also be some swelling of the nerve which can occur during surgery. This would cause weakness of the nerve several days after the surgery. Should the nerve actually be transected or cut, or it be necessary to remove the nerve with the tumor, there may be permanent paralysis, or injury to the muscles of facial movement on that side of the face.
Other possible adverse outcomes following parotid surgery include, recurrence of the tumor. The likelihood of this would really depend on the type of tumor, and its location in the gland. Other adverse outcomes include, gustatory sweating or so called Frye Syndrome when over time, after the wound has healed, the patient may perspire into the area of facial skin over the transected parotid gland. This is due to the attachment of the parotid nerve fibers into the skin. This can usually be treated with antiperspirants, or surgical correction is also available. Other complications include, hemorrhage under the facial flap overlying the parotid bed. This can occur early in the postoperative period.
In addition, patients undergoing a parotidectomy will experience some numbness, and some permanent loss of sensation over the ear, due to the proximity of the sensory nerves that usually are sacrificed during the parotid surgery. A small drain is usually placed behind the ear after the parotidectomy is performed, and this is attached to a suction canister which is collapsed and spring-loaded, providing constant suction to the drain. The canister should remain flattened throughout the postoperative course until it is removed by the doctor. A large head bandage will be applied following the surgery, and as this surgery is usually performed on an outpatient basis, will usually be removed by Dr. Durante, or Dr. Patel in the office the following day. The drain itself will usually remain in for another four to six days, and then this will be removed in the office. Again, a bulky head dressing will be applied for at least a day, and then this will be removed at home by the patient.
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