A potentially serious complication, as infection can spread via the fascial planes of the neck. It can rarely affect the spaces in the floor of the mouth and cause Ludwig angina.
long term
high
A hypofunctional salivary gland can result in decreased saliva production and protection against acid erosion, leading to dental decay.
variable
low
Following superficial parotidectomy, transient facial nerve palsy occurs in approximately one third to two-thirds of patients.[51]Moody AB, Avery CM, Walsh S, et al. Surgical management of chronic parotid disease. Br J Oral Maxillofac Surg. 2000;38:620-622.
http://www.ncbi.nlm.nih.gov/pubmed/11092780?tool=bestpractice.com
[52]Moody AB, Avery CM, Taylor J, et al. A comparison of 150 consecutive parotidectomies for tumours and inflammatory disease. Int J Oral Maxillofac Surg. 1999;28:211-215.
http://www.ncbi.nlm.nih.gov/pubmed/10355945?tool=bestpractice.com
[53]Amin MA, Bailey BM, Patel SR. Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study. Br J Oral Maxillofac Surg. 2001;39:348-352.
http://www.ncbi.nlm.nih.gov/pubmed/11601814?tool=bestpractice.com
[54]Patel RS, Low TH, Gao K, et al. Clinical outcome after surgery for 75 patients with parotid sialadenitis. Laryngoscope. 2007;117:644-647.
http://www.ncbi.nlm.nih.gov/pubmed/17415134?tool=bestpractice.com
Cosmetic deformity is relatively minor, but recurrent symptoms may occur in up to 11% to 13%,[51]Moody AB, Avery CM, Walsh S, et al. Surgical management of chronic parotid disease. Br J Oral Maxillofac Surg. 2000;38:620-622.
http://www.ncbi.nlm.nih.gov/pubmed/11092780?tool=bestpractice.com
[53]Amin MA, Bailey BM, Patel SR. Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study. Br J Oral Maxillofac Surg. 2001;39:348-352.
http://www.ncbi.nlm.nih.gov/pubmed/11601814?tool=bestpractice.com
although not all require further treatment. A subtotal parotidectomy cosmetic defect is more marked and the risk to the facial nerve is probably slightly higher, although this has not been demonstrated.[54]Patel RS, Low TH, Gao K, et al. Clinical outcome after surgery for 75 patients with parotid sialadenitis. Laryngoscope. 2007;117:644-647.
http://www.ncbi.nlm.nih.gov/pubmed/17415134?tool=bestpractice.com
The incidence of recurrent symptoms is possibly lower, <4%,[54]Patel RS, Low TH, Gao K, et al. Clinical outcome after surgery for 75 patients with parotid sialadenitis. Laryngoscope. 2007;117:644-647.
http://www.ncbi.nlm.nih.gov/pubmed/17415134?tool=bestpractice.com
although fewer recurrences occurred with a superficial parotidectomy in this series. The extent of the disease and preferences of the patient will also influence the choice of surgical procedure. The pattern of facial weakness is likely to involve one or more nerve branches and is commonly panfacial,[51]Moody AB, Avery CM, Walsh S, et al. Surgical management of chronic parotid disease. Br J Oral Maxillofac Surg. 2000;38:620-622.
http://www.ncbi.nlm.nih.gov/pubmed/11092780?tool=bestpractice.com
[52]Moody AB, Avery CM, Taylor J, et al. A comparison of 150 consecutive parotidectomies for tumours and inflammatory disease. Int J Oral Maxillofac Surg. 1999;28:211-215.
http://www.ncbi.nlm.nih.gov/pubmed/10355945?tool=bestpractice.com
because of widespread fibrosis within the gland. Recovery is typically over a 3- to 6-month period and usually complete. Permanent palsy occurs in <1%.[51]Moody AB, Avery CM, Walsh S, et al. Surgical management of chronic parotid disease. Br J Oral Maxillofac Surg. 2000;38:620-622.
http://www.ncbi.nlm.nih.gov/pubmed/11092780?tool=bestpractice.com
[52]Moody AB, Avery CM, Taylor J, et al. A comparison of 150 consecutive parotidectomies for tumours and inflammatory disease. Int J Oral Maxillofac Surg. 1999;28:211-215.
http://www.ncbi.nlm.nih.gov/pubmed/10355945?tool=bestpractice.com
[53]Amin MA, Bailey BM, Patel SR. Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study. Br J Oral Maxillofac Surg. 2001;39:348-352.
http://www.ncbi.nlm.nih.gov/pubmed/11601814?tool=bestpractice.com
[54]Patel RS, Low TH, Gao K, et al. Clinical outcome after surgery for 75 patients with parotid sialadenitis. Laryngoscope. 2007;117:644-647.
http://www.ncbi.nlm.nih.gov/pubmed/17415134?tool=bestpractice.com
The incidence of hematoma, seroma, or significant infection should be <5%.[51]Moody AB, Avery CM, Walsh S, et al. Surgical management of chronic parotid disease. Br J Oral Maxillofac Surg. 2000;38:620-622.
http://www.ncbi.nlm.nih.gov/pubmed/11092780?tool=bestpractice.com
[52]Moody AB, Avery CM, Taylor J, et al. A comparison of 150 consecutive parotidectomies for tumours and inflammatory disease. Int J Oral Maxillofac Surg. 1999;28:211-215.
http://www.ncbi.nlm.nih.gov/pubmed/10355945?tool=bestpractice.com