Parotidectomy Flashcards
What is the biggest concern for a Parotidectomy?
Facial Nerve and its branches
What are the five branches of the Facial Nerve?
- Temporal
- Zygomatic
- Buccal
- Mandibular
- Cervical
What are some causes of a Parotidectomy?
- Blockage of gland due to swelling
- Cancer
What is Patient Positioning for a Parotidectomy?
- Supine
- Operative side arm tucked
- Head turned away from operative side
- Neck extended
- Shoulder roll under Scapula
- Head in ring pillow
Where is the skin incision made for a Parotidectomy?
- Down the front of ear
- Around the base of ear
- Down jawline
- Around neck (if necessary)
What step is after the skin incision in a Parotidectomy?
- Dissect skin of Parotid gland superficially
- Use sharp hook retractor to lift straight up
- Dissect Sternocleidomastoid off of Parotid gland
How can we use self-retaining retractors during Parotidectomies?
Reflect skin flaps using suture to free hands
What step is done after dissecting the Sternocleidomastoid?
- Identifying the Facial Nerve
- Dissecting Parotid gland around Facial Nerve branches
Why is Monopolar Electrocautery not used for dissection in a Parotidectomy?
Electric current is not focused and you can damage the Facial Nerve causing paralysis
What is the next step after removal of the Parotid gland?
- Testing of the Facial Nerve branches using NIMs
- Placement of Drain
What is used to fill a defect after a Parotid gland removal?
Sternocleidomastoid muscle (3-0 Vicryl on an SH needle)
What are the steps for closure of a Parotidectomy?
- Dermis closed using 3-0 Vicryl on an SH needle
- Deep Buried Interrupted
- Skin closed using 4-0 Monocryl on a PS2 needle
- Intracuticular
- Drain secured using 3-0 Nylon
- Roman Sandal
What dressing is used for a Parotidectomy?
Dermabond to seal the skin
