Parotidectomy is the removal of part or all of the parotid gland on one side of the face. Understanding the anatomy of the facial nerve in relation to the parotid gland is key to understanding surgery.
Superficial parotidectomy: The parotid gland is artificially divided into a superficial and deep lobe by the facial nerve, which runs in a fixed plane in the middle of the gland. A superficial parotidectomy requires removal of the parotid gland, which is superficial to the plane of the facial nerve. This is the most common parotid surgery. Less than a full superficial parotidectomy, but one that still has the entire tumor removed with a negative margin may also be called a partial parotidectomy. .
Total parotidectomy: This requires removal of the entire parotid gland, including the superficial and deep lobe. If the facial nerve is not involved, this requires identifying all branches and carefully pulling them out while performing meticulous dissection.
Radical parotidectomy: This procedure is a total parotidectomy with resection of the facial nerve. An extended radical parotidectomy will also involve removing additional structures such as the temporal bone or facial skin overlying the parotid gland.
In some cases, additional procedures may be done at the same time as the parotidectomy. For example, some types of parotid cancer may show neck dissection, a temporary bone resection may be required if some or all of the facial nerve has to be sacrificed, or if a parotid cancer is growing.