Difference between revisions of "Parotidectomy"
From WikiAnesthesia
Chris Rishel (talk | contribs) |
|||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = | | anesthesia_type = General | ||
| airway = | | airway = ETT | ||
| lines_access = | | lines_access = PIV | ||
| monitors = | | monitors = Standard | ||
5-lead ECG | |||
Facial nerve monitoring | |||
| considerations_preoperative = | | considerations_preoperative = | ||
| considerations_intraoperative = | | considerations_intraoperative = | ||
| Line 9: | Line 11: | ||
}} | }} | ||
A '''parotidectomy''' is a surgical procedure to remove some or all of the parotid gland. | |||
== Overview == | == Overview == | ||
=== Indications === | === Indications === | ||
Tumor of parotid gland | |||
* Tumor of parotid gland | |||
=== Surgical procedure === | === Surgical procedure === | ||
Total: removal of parotid gland lateral and medial to facial nerve, often combined with neck dissection. | * Superficial: removal of parotid gland lateral to facial nerve. | ||
* Total: removal of parotid gland lateral and medial to facial nerve, often combined with neck dissection. | |||
Radical: removal of parotid gland with facial nerve | * Radical: removal of parotid gland with facial nerve | ||
== Preoperative management == | == Preoperative management == | ||
| Line 154: | Line 158: | ||
== References: == | == References: == | ||
[[Category:Surgical procedures]] | [[Category:Surgical procedures]] | ||
[[Category:Otolaryngology]] | |||
Latest revision as of 23:54, 4 April 2022
Parotidectomy
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access |
PIV |
| Monitors |
Standard 5-lead ECG Facial nerve monitoring |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A parotidectomy is a surgical procedure to remove some or all of the parotid gland.
Overview
Indications
- Tumor of parotid gland
Surgical procedure
- Superficial: removal of parotid gland lateral to facial nerve.
- Total: removal of parotid gland lateral and medial to facial nerve, often combined with neck dissection.
- Radical: removal of parotid gland with facial nerve
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
- As indicated by H&P
Operating room setup
- Facial nerve stimulator
Patient preparation and premedication
- Routine
Regional and neuraxial techniques
- N/A
Intraoperative management
Monitoring and access
- Standard monitoring
- 18G PIV x 1
Induction and airway management
- Standard induction avoiding long acting paralytic (succinylcholine or remifentanil)
- ETT taped to opposite side.
Positioning
- Supine
- Head turned to opposite side
- Bed may be turned 90 or 180 degrees
Maintenance and surgical considerations
- Volatile anesthetic or TIVA
- Avoid long acting paralytic to allow for facial nerve, monitoring, consider remifentanil to maintain a still patient, facial nerve monitoring by surgeon
Emergence
Postoperative management
Disposition
PACU
Pain management
Potential complications
- Bleeding
- Infection
- Dysesthesia of greater auricular nerve
- Facial nerve weakness
- Frey's syndrome
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | 1.5-2 | |
| EBL | 25-200 | |
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References:
Top contributors: Olivia Sutton, Ed Nguyen, Chris Rishel and Barrett Larson