A minimally invasive procedure pioneered by Dr. Babak Larian, micro-parotidectomy is a revolutionary way to treat parotid tumors through the full or partial removal of the parotid gland.
What is Micro-Parotidectomy?
During the micro-parotidectomy procedure, or minimally invasive parotid surgery, Dr. Larian will remove all or a portion of the parotid gland through a very small and well-hidden incision near the ear - an approach that results in reduced pain, minimal scarring, and a quicker recovery. At the same time, Dr. Babak Azizzadeh, a leading facial nerve specialist and facial plastic surgeon, will monitor the facial nerve to ensure its safety and reduce the risk of surgical complications. Once the parotid tumor has been located and removed by Dr. Larian, Dr. Azizzadeh will then perform a reconstructive procedure to fill in the defect left behind by the removed portion of the gland. In addition to restoring symmetry to the face, this corrective procedure provides an added layer of protective tissue on top of the facial nerve, which helps prevent Frey's Syndrome. To achieve this, Dr. Azizzadeh will use muscle flaps, grafts or a combination of these, dependent on the needs of each individual patient, to provide a positive aesthetic outcome and ensure the patient experiences minimal to no scarring. Micro-parotidectomy is commonly performed as an outpatient procedure; most patients do not require hospitalization and can return home the same day as surgery.
Benefits of Micro-Parotidectomy:
- Minimally invasive & smaller incision
Results in a smaller scar, less pain, less tissue trauma, less blood loss, and faster recovery. - Facial nerve monitoring and preservation
Monitoring of facial nerve function and preservation of its branches for maximum nerve function. - Preservation of the greater auricular nerve
The greater auricular nerve is responsible for providing sensation to the lower part of the ear lobes and the skin of the face. - Facial reconstruction
Provides a better aesthetic outcome by recreating a more even and balanced facial appearance. - Decreased risk of Frey's syndrome
Frey's syndrome is an unpleasant and too often experienced side effect of traditional parotid surgery.
THE EVOLUTION OF THE PAROTIDECTOMY
The minimally invasive micro-parotidectomy is the most cutting edge parotid removal technique available today. Although Dr. Larian and his team strive to use this advanced approach whenever possible, in some cases other more extensive parotid removal techniques may be required. Because of the variety of cell types, there are many different types of tumors and cancers that can develop in the parotid gland. As such, the type of parotid surgery that will yield the best results for the patient is dependent on the size, location, and severity of the tumor or disease.
During your consultation at the CENTER for Advanced Parotid & Facial Nerve Surgery in Beverly Hills, Dr. Larian will thoroughly examine you, analyze any imaging studies that have been performed, and perform a needle biopsy of the tumor to determine if it is cancerous or not. Once we have determined what type of tumor or cancer the patient has, we can determine which parotid removal surgery is best. The most common type of parotid tumor is a pleomorphic adenoma, which is a benign tumor but has little finger-like projections around it that need to be removed or else you run the risk of it growing or reoccurring. Additionally, pleomorphic adenoma has the potential and risk of turning into an aggressive cancer. So not only does it need to be removed, but an expert must do it, because if any of it is left behind, in time it will regrow and can become a cancer. The only treatment for pleomorphic adenoma is surgery.
Our goal is to provide our patients with the best parotid surgery outcomes, alongside the most trusted and compassionate care. As such, our entire team is here for you to help you along every step of the way.
The Micro-Parotidectomy Incision
The micro-parotidectomy is the most minimally invasive technique available and involves a minute incision near the ear to minimize scarring, recovery time and long-term complications. At the CENTER, every micro-parotidectomy is performed by both Dr. Larian and Dr. Azizzadeh, as we have found that a team approach to this surgery provides patients with significantly better results. Utilizing the expertise of both surgeons, not only can the patient rest assured they are in the hands of the best parotid removal surgeons, but they also benefit from facial reconstruction to ensure a symmetrical cosmetic appearance following surgery. Having perfected the micro-parotidectomy, Dr. Larian and his team use it whenever possible to ensure optimal surgical outcomes and provide the best parotid surgery available.
As with any surgery, there are risks involved. Because the parotid gland has such a close relationship with the facial nerve, it is vital the parotid tumor is removed by a team of surgeons with vast experience in parotidectomy to mitigate risks. Alongside our team's unparalleled surgical experience, we take every safety measure and precaution possible before, during and after surgery to protect and preserve the facial nerve. Therefore, the occurrence of permanent facial paralysis after parotidectomy is extremely low at our practice (less than 0.1%). In addition to preserving the facial nerve, we also go to great lengths to protect the greater auricular nerve, which is in charge of providing sensation to the ear lobe. The incidence of Frey's syndrome is also greatly reduced to less than 1% due to the fact that our team of parotid surgeons immediately reconstructs the area and covers the facial nerve. When needing surgery on such an important area of the face, it is extremely important to find a surgeon who regularly performs micro-parotidectomy to protect you from these unwanted (and unnecessary) complications. At the CENTER for Advanced Parotid & Facial Nerve Surgery you can trust you are in the hands of the top micro-parotidectomy surgeons.
The Facelift Incision
As surgical techniques advanced, the next phase in the evolution of parotid surgery was the facelift incision, which opened the door for simultaneous facial reconstruction surgery. The use of the facelift incision results in less scarring than the traditional parotidectomy and a better aesthetic outcome. It allows for access to the facial nerve and greater auricular nerve, as well as critical muscles that are necessary for cosmetic reconstruction. Dr. Larian and his team still use the facelift incision when the tumor is positioned in a way that prohibits visibility of the facial nerve with a micro-parotidectomy.
The Traditional Parotidectomy Incision
A traditional parotidectomy is performed through a Modified Blair Incision. During the procedure, an incision several inches in length is made extending from the top of the ear down toward the jaw. From there, the surgeon is able to visualize the entire side of the face, including the parotid gland and facial nerve.
Although this approach is still useful when the removal of lymph nodes is also required, it's simply not necessary in most cases. Additionally, very few surgeons perform facial reconstruction at the same time as a traditional parotidectomy, leaving patients with a large defect or hollowness in the face where the gland used to be.
Learn more about traditional parotidectomyMeet The Team
Led by board-certified parotid surgeon, Dr. Babak Larian, our team of specialists has decades of experience successfully diagnosing and treating diseases of the parotid glands with minimally invasive procedures. Distinguished by our compassionate care and cutting-edge techniques, the CENTER has developed a reputation for delivering the best parotid tumor surgery available.
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