You have two parotid glands which are located just in front of your ears. These produce saliva which flows into the mouth.
Lumps can occur in the parotid gland due to the abnormal overgrowth of part of the salivary gland (a parotid gland tumour) , lymph node swelling within the gland or blockage of the drainage.
Most of these swellings are benign, which means that they are not cancerous and do not spread to other parts of the body.
Rarely, malignant tumours can also affect the gland. Your specialist will investigate the lump with ultrasound or MR scanning and will probably carry out a fine needle aspiration (a needle sample from the lump) to diagnose the cause of the swelling.
Although 80% of these lumps are benign we usually recommend that they are removed since they continue to grow slowly and after many years a benign lump may become malignant. The larger the lump, the more difficult it is to remove. Often the final diagnosis can only be made when the whole lump is examined in the laboratory.
This is the operation to remove part or all of the parotid gland. The operation is performed under general anaesthesia. An incision is made which follows the skin crease just in front of your ear and down into your neck. This scar heals very well and is a similar incision to that used in "face lift" surgery. At the end of the operation the surgeon will place a drain (plastic tube) through the skin to prevent any blood collecting under the skin. This is usually removed the next day. Most patients will require 24 - 48 hours in hospital after the operation. You will need to stay off work for about 2 weeks.
Facial weakness: There is an important nerve (facial nerve) which passes through the parotid gland. Damage to this nerve during the surgery can lead to a weakness of the face (facial palsy). In most cases the nerve works normally after the surgery, however occasionally (about 15-20% of cases), where the tumour has been very close to the nerve, a temporary weakness of the face can occur which lasts for several weeks. In 1% of cases there is a permanent weakness of the face following this sort of surgery for benign tumours.
Numbness around the ear: The skin at the front of the ear may be numb for several weeks after the operation, and the ear lobe may be numb permanently.
Blood clot: A blood clot can collect beneath the skin (a haematoma). This is quite rare and it is sometimes necessary to return to the operating theatre and remove the clot.
Salivary leakage: In 2-5% of patients the cut surface of the parotid gland leaks a little saliva which can collect under the skin. If this happens it may be necessary to remove the saliva using a needle.
Frey's syndrome: Some patients find that after this surgery their cheek can become red, flushed and sweaty whilst eating. This is because the nerve supply to the gland can re-grow into the sweat glands of the skin. This is a rare complication.