Parotidectomy, complications and management: our experience


  • Pranabashish Banerjee Department of ENT, NRS Medical College, Kolkata, West Bengal, India
  • B. Sikdar Department of ENT, NRS Medical College, Kolkata, West Bengal, India
  • Gautam Das North Bengal Medical College, Siliguri, West Bengal, India
  • Arijit Das North Bengal Medical College, Siliguri, West Bengal, India
  • Arunava Ghosh North Bengal Medical College, Siliguri, West Bengal, India



Parotidectomy, Facial nerve palsy, Parotid fistula, Frey’s syndrome


Background: Salivary gland neoplasms constitute 0.3% of all malignancies and 2%-6.5% of the head-and-neck tumors. Considering the unique anatomy of the gland and its intricate relationship with the facial nerve, significant complications may arise which can result in varying degrees of morbidity.

Methods: We present here our experience of Parotid surgery done at two institutes, NRS medical College in Kolkata and North Bengal medical College and Hospital in the Darjeling district from 2013 to 2019 in the department of ENT and Head neck Surgery. Patients were subjected to superficial parotidectomy, total conservative and total parotidectomy depending upon the preoperative FNAC report.

Results: 47 patients were subjected to different types of parotidectomies.  Pleomorphic adenoma was the most common pathology encountered and facial nerve palsy was the most common post-operative complication in our series, followed by GAN injury, flap necrosis and Frey’s syndrome.

Conclusions: This demographic study will help future parotid surgeons to understand various complications encountered during the surgery and management of those aforesaid complications, improving surgical outcome.

Author Biography

Pranabashish Banerjee, Department of ENT, NRS Medical College, Kolkata, West Bengal, India

Associate Prof

Department of ENT

NRS Medical College and Hospital


Vesalius A. De humani corporis fabrica libre septem. Basileae: Ex officina Ioannis Oporini. Available at: Accessed on 25 May 2020.

Heister L. A general system of surgery in three parts. London: W. Innys, C Davis. Available at: https:// 08/01/a-general-system-of-surgery-in-three-parts-by-laurence-heister-1743/. Accessed on 25 May 2020.

Parkin DM, Whelan SL, Ferlay J. Cancer Incidence in Five Continents. Available at: http://www.iacr. Accessed on 25 May 2020.

Ellis GL, Auclair PL, Gnepp DR. Major Problems in pathology. In: Ellis GL, Auclair PL, Gnepp DR. Surgical pathology of the salivary glands. 2nd ed. Philadelphia: Saunders; 1991:61-91.

O'Brien C. Drug addiction and drug abuse. In: Brunton LB, Lazo JS, Parker KL, eds.Goodman & Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2005: 607-29.

Bailey H. The treatment of tumours of the parotid gland with special reference to total parotidectomy. Br J Surg. 1941;28(11):337-46.

Bailey H. Parotidectomy: indications and results. Br Med J. 1947; 4499(1):404-7.

Shucksmith HS, Boyle TM, Walls WK. The surgery of parotid tumours; exposure of main trunk of facial nerve. Br Med J. 1951;4735(2):830-1.

Martin H. The operative removal of tumors of the parotid salivary gland. Surgery. 1952;31(5):670-82.

Bhagavan BC, Pandudasappa, Ganesh RK, Sachin KG. Surgical complications and its management after parotidectomy: Our 4 years’ experience. International Journal of Surgery Science. 2019;3(4): 338-41.

Infante-Cossio P, Gonzalez-Cardero E, Garcia-Perla-Garcia A, Montes-Latorre E, Gutierrez-Perez JL, Prats-Golczer VE. Complications after superficial parotidectomy for pleomorphic adenoma. Med Oral Patol Oral Cir Bucal. 2018;23(4):e485-92.

Laccourreye H, Laccourreye O, Cauchois R, Jouffre V, Menard M, Brasnu D. Total conservative parotidectomy for primary benign pleomorphic adenoma of the parotid gland: a 25-year experience with 229 patients. Laryngoscope. 1994;104:1487-94.

Grewal R, Xu J, Sotereanos DG, Woo SL. Biomechanical properties of peripheral nerves. Hand Clin. 1996; 12:195-204.

Hui Y, Wong DSY, Wong LY, Ho WK, Wei WI. A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy. Am J Surg. 2003;185:574-9.

Porter MJ, Wood SJ. Preservation of the great auricular nerve during parotidectomy. Clin Otolaryngol Allied Sci. 1997;22:251-3.

Mandour MA, El-Sheikh MM, El-Garem F. Tympanic neurectomy for parotid fistula. Arch Otolaryngol 1976; 102:327-9.

Shimm DS, Berk FK, Tilsner TJ, Coulthard SW. Low-dose radiation therapy for benign salivary disorders. Am J Clin Oncol. 1992;15:76-8.

Staffieri A, Marchese Ragona R, De Filippis C, Tugnoli V. Management of parotid fistulae and sialoceles with botulinum toxin. Otolaryngol Head Neck Surg. 1999;121:P240-1.

Bjerkhoel A, Trobbe O. Frey’s syndrome: treatment with botulinum toxin. J Laryngol Otol. 1997;111:839-44.

Laccourreye O, Akl E, Gutierrez-Fonseca R, Garcia D, Brasnu D, Bonan B. Recurrent gustatory sweating (Frey syndrome) after intracutaneous injection of botulinum toxin type A: incidence, management, and outcome. Arch Otolaryngol Head Neck Surg. 1999;125:28.






Original Research Articles