How long does the surgery take to perform? A typical submandibular gland excision takes 1 hour.

What is the recovery time like? Typically patients are back to normal and feeling well after 4-5 days.

Will I need to stay overnight in the hospital? Most people are discharged the same day. Depending on the extent of dissection however, you may be required to stay overnight.

Any dietary restrictions after the surgery? None. You may eat and drink normally after your surgery.

Can I speak after surgery? You may use your voice immediately after the surgery.

Will I be sent home with any medications? You will be given pain medications and antibiotics.

What types of activities can I perform after surgery? I would not recommend heavy lifting or straining immediately after surgery. You can resume heavy lifting and straining 1 week after surgery.

When do I come in for my follow-up visit? You should be seen 1-2 weeks following surgery.

Will my stitches need to be removed? All the stitches will be dissolvable, and we do not need to remove any of them.

What are the risks of submandibular gland surgery? Aside from possible bleeding and infection, the major risk of submandibular gland surgery is weakness of the marginal mandibular branch of the facial nerve (nerve to the corner of the mouth) and facial asymmetry. However, the risk of permanent injury in experienced hands is in the order of 3-5%. The vast majority of patients undergoing submandibular gland surgery however, have no problems with their facial nerve after surgery.

Other risks include tongue numbness or tongue paralysis. Luckily these complications are even more rare.

Are there ways to minimize the injury to the facial nerve during submandibular gland excision?

There are some surgical techniques that can be employed to protect the nerve during surgery. Additionally, we can consider the use of the facial nerve monitor.

There are several practitioners in my area who perform parotid surgery. How should I choose one? Are there questions I should ask during the consultation?

There are a few things to consider when deciding on a surgeon.

Ask how many parotid surgeries the surgeon has done during the past three months to get a sense of his/her experience. Dissecting the branches of the facial nerve safely is technically challenging. So make sure that you choose someone who has the requisite technical skills.

Ask if your surgeon is fellowship trained in head and neck surgery. There are many competent parotid surgeons who have not had fellowship training. Nevertheless, this is something that allows you as a patient to understand how up-to-date your surgeon is with new techniques. You can safely assume that a head and neck fellowship trained surgeon is doing parotidectomies on a regular basis.

Ask if your surgeon uses facial nerve monitoring. Successful parotidectomy does not always require the use of laryngeal nerve monitoring, but there has been a positive trend towards the use of monitoring during parotidectomy. If you are undergoing parotidectomy, you should have the state of the art technology available in order to minimize the chance of an injury to your facial nerve.

In the end, the decision to choose a surgeon is a very personal one. Don’t be rushed through the pre-operative consultation. Make sure that you can trust what your surgeon has to say, make sure that you have adequate time to get an answer to all of your questions, and make sure that you have been able to establish a rapport with the surgeon.