Parotidectomy
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Revision as of 18:12, 4 April 2022 by Barrett Larson (talk | contribs)
Parotidectomy
Anesthesia type | |
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Airway | |
Lines and access | |
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Primary anesthetic considerations | |
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Intraoperative | |
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Provide a brief summary of this surgical procedure and its indications here.
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 |
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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 | |
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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