The parotid gland is a paired gland found on either side of the head just in front of the ear, and is the largest of the salivary, or spit-producing glands. Other salivary glands include the submandibular glands under the jaw, the sublingual glands under the tongue, and the numerous minor salivary glands throughout the mouth and throat. The parotid gland is primarily responsible for producing saliva in response to a stimulus, such as a sour candy or lemon. Saliva is very important for breaking down starches, has substances to fight infection, and protects the teeth. The parotid gland may have to be removed surgically when there is a benign or cancerous tumor (pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, etc), or someone has chronic inflammation and repeated infections from salivary stones. Some tumors may cause facial paralysis.
In order to perform parotidectomy, head and neck surgeons (including Drs. Genden, Berger, Chai, Khan, Kirke, Roof, Teng, Urken, Shin, and Zeiger) must find the facial nerve, which controls a patient’s facial expressions, and remove the gland and tumor from the nerve. Using specialized stimulating instruments, Mount Sinai surgeons are able to monitor the nerve throughout the procedure. If the patient has facial paralysis from a malignant tumor, facial plastic surgeons are able to perform a variety of procedures to help with eye closure and smile. These may include an eyelid weight, gracilis free flaps, nerve transfers, cross-face nerve grafts, masseteric-facial nerve grafts, hypoglossal-facial nerve grafts, temporalis tendon transfer, tensor fascia lata slings, and ectropion repair.
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The Mount Sinai Otolaryngology Surgical Video Series was edited by Dr. Zachary Schwam.
