Tuesday, May 3, 2016

ENT Procedure 15 parotidectomy

Parotidectomy
Objective
In cases of disease of Parotid:
•   Excision of all or superficial portion of the salivary gland.
Position
Supine.
Anesthesia
General.
Procedure
1.  An incision in the preauricular region, continued inferiorly around the earlobe, and then anteriorly along sternomastoid.
2.  The fascia is incised.
3.  Careful exposure of the facial nerve is necessary.
4.  A nerve stimulator can be used to help in its identification.
5.  The superficial portion of the gland may be resected after blunt and sharp dissection.
6.  Removal of the deeper portion may be necessary for malignancy.
7.  Stenson’s duct is ligated and divided.
8.  The wound is closed often employing a drain.
Instruments
•   Minor procedure set 
•   Thyroid set 
•   Extra right-angle clamps 
•   Nerve hook 
•   Basin set 
•   Blades (1) No. 10 (3) No. 15 
•   Suction tubing 
•   Dissector (e.g. peanut) 
•   Bulb syringe 
•   Marking pen 
•   Drain (e.g. 1/4" Penrose, Hemovac) 
•   Sterile, plastic adhesive drape (optional) 
•   Nerve stimulator (locator)

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