There are many aspects of parotid surgery that concern patients, and one of the primary concerns is the incision used during parotid surgery. The treatment is on a highly visible area of the body-the face- and can lead some patients to worry about what the resulting scar may look like after surgery.

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me to provide information about incision types used during parotid surgery to help alleviate the anxiety that patients may feel about the incisional scar.

Listen in as Dr. Moore provides valuable information on a variety of topics related to incisions!

Key Talking Points of the Episode:

• Incision Types
• Factors Affecting Incision Type Selection
• Incisions for Superficial vs. Deep Lobe Tumors
• Incisions for Parapharyngeal Space Tumors
• Incisions for Accessory Parotid Gland Tumors
• Closure of Incisions
• Post-Operative Incisional Side Effects and Care
• Scar Revision Options

Key Milestones of the Episode:

[01:10] Factors Affecting the Incision Type

[05:23] Why do surgeons vary on the type of incision used during parotid surgery?

[07:20] Incision Types for Superficial Lobe versus Deep Lobe Tumors

[11:15] Is it necessary to remove the entire parotid gland to remove a deep lobe tumor?

[12:45] Do all patients require the standard parotid incision that extends into the crease of the neck?

[18:02] Use of hairline incisions behind the ear.

[22:06] Can parotid tumors be removed through the mouth?

[25:34] Are endoscopic salivary gland approaches available for parotid tumor removal?

[27:57] Incisions for Accessory Parotid Gland Tumors

[35:36] Incisions for Parapharyngeal Parotid Tumors

[37:18] Is it necessary to break a patient’s jaw to remove a tumor in the parapharyngeal space?

[38:45] Surgical Approach for Parapharyngeal Space Tumors

[41:48] Incision Types for Tumors in the Sublingual and Submandibular Glands

[44:44] Minimally Invasive Incisions

[48:21] Is there a correlation between incision size and recurrences?

[50:53] Extracapsular Dissection

[54:56] Revision Surgery Incisions after Recurrence

[57:41] Closure of Incisions

[01:00:10] Post-Surgical Care of Incisions

[01:09:32] Surgical Side Effects Related to Incisions

[01:19:42] Scar Revision Options

Informational References from the Episode:

https://parotidtumorpodcast.buzzsprout.com/1267148/8098929-parotid-surgery-part-1

https://parotidpatientproject.org/resources/mayo-clinic-parotid-tumor-guide-videos.html

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

It is parotid patient question and answer day at Parotid Tumor Podcast! Patients often share the same worries, concerns, and experiences as they navigate this diagnosis and treatment process. A great way to educate yourself and to become your own best advocate is by learning through questions that have been asked by fellow parotid patients.

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me to answer patient questions on a variety of parotid related topics. Dr. Moore will be sharing important information about benign and malignant masses, treatment side effects, recurrences, current research projects, and much more!

Listen in as Dr. Moore answers excellent questions that were submitted by the parotid community that will help educate and empower patients!

Please refer to the Chapter Markers for time stamps for each patient question.

Key Talking Points of the Episode:

• Enlarged Lymph Nodes vs. Parotid Tumors
• Treatment of Warthins Tumors
• Use of Ablation Techniques for Parotid Tumors
• Treatment Options for Malignant Parotid Tumors
• Treatment Side Effects
• Parotid Tumor Recurrences
• Parotid Tumor Research and Advanced Treatment Options

Key Quotes from the Episode:

“Individualizing treatment is always a good practice.”

“In this country, we are not very keen on the idea of ablation type treatment, such as radiofrequency ablation or injection ablation of benign tumors in the parotid gland….the two problems with doing that in the parotid gland are one, the uncertainty of diagnosis, so you may potentially be ablating a benign tumor that is actually malignant, and the relationship of the tumor to the facial nerve.”

“Every decision to perform surgery or not to perform surgery or to perform any kind of treatment- I’ll even be more general- is a balance between a risk and benefit ratio.”

“What I usually tell patients is you know you have to go into the treatment having faith in your care providers that they are going to do exactly the right thing that they would want done for them to you, and then you have to have faith and positivity that treatment is going to be effective until proven that treatment is not effective and so having a powerful mindset of positivity I think helps you get through this period of adversity as well as anything.”

“If the facial nerve is intact, it should go back to normal in almost every single circumstance.”

“I definitely believe that parotid gland surgery volume leads to experience, which leads to better outcomes.”

“To do research requires core groups and funding and numbers of people and numbers of specimens, and those are lacking in many of the parotid gland tumors, and that’s why there is not a whole lot of beneficial research at the basic science level on genomics and novel targeted therapeutics actively being undertaken in those tumors.”

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

The day we have all been waiting for has finally arrived! A patient-centered research project at the Mayo Clinic that was funded by Parotid Patient Project is being released. As patients, we often wonder why we don’t have more answers about parotid tumors, why our medical teams often don’t understand what we go through during this process, why more advanced treatment options are not available, and why more attention has not been focused on this disease process?

In this episode, Dr. Linda Yin, Head and Neck Surgeon, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, joins me to explain the details about this research project, to explain the answers she hopes to find through this study, and shares her thoughts on how our voices can be used to help improve the management, care, and treatment of parotid tumors.

We all have a unique opportunity to let our voices be heard and to help influence the care of future parotid patients by participating in this research study. It is time for the parotid community to come together and build a coalition of patients, doctors, and researchers to work together toward the goal of improving parotid patient care.

Listen in to the episode and learn how you can join us in the fight for more answers and better treatment options for parotid patients!

Join the Research Project:

You can sign up for this research study by clicking this link:

https://surveys.mayoclinic.org/jfe/form/SV_0CBqkIUwp90mJW6

Key Quotes from the Episode:

“While we’re very passionate about parotid tumors and obviously those that are listening to this podcast and any patient who has been afflicted by a parotid tumor can attest that this takes up a significant portion of their energy and really changes their life to have this diagnosis. On a population level, it is still quite a rare disease process and that creates a few challenges.”

“When we think about medicine today, we really feel that outcomes should not just be judged by if we, as the surgeon, feel that we did a good job but by how the patient feels.”

“On the most and simplest level, what the study aims to do is just open up better communication and explore the patient experience in a more detailed and comprehensive way.”

“The voice of the patient is the only thing that really matters in this study.”

“Every patient voice matters and there is a big diversity of experiences that people go through, and we want to try to capture and understand all of it in this comprehensive survey.”

“By letting your voice be heard that is the most important way to help.”

“It is our hope that this outcome measure that we develop through this survey can be implicated and can be used on a wider basis by surgeons around the country and even around the world to be administered to patients.”

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

It is parotid patient question and answer day at Parotid Tumor Podcast! Patients often share the same worries, concerns, and experiences as they navigate this diagnosis and treatment. Patients also have many of the same questions about the process, and the future diagnosis and treatment possibilities.

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me to answer patient questions on a variety of parotid related topics. Dr. Moore will be sharing important information about potential causes of parotid tumors, diagnostic tests, lymph nodes, recurrences, and much more!

Listen in as fellow parotid patients, and Dr. Moore help us educate and empower patients!

Key Talking Points of the Episode:

• Bilateral Parotid Tumors
• Cell phone usage and parotid tumors
• Lymph node removal during parotid surgery
• Surgical Incisions
• Parotid Tumor Recurrences
• Parotid Tumor Research

Key Quotes from the Episode:

“The vast majority of the evidence has not been able to associate cell phone usage with parotid gland tumors.”

“I do actually think we are going to get there with big data, and artificial intelligence that I think we will be able be able to make accurate diagnoses of parotid gland tumors just by imaging alone once we get a big enough data set that we can correlate with pathology. That would be a big step forward I think.”

“The only real way to ensure that a lymph node is malignant or benign is by histopathology- looking at it under the microscope- and seeing those changes in the cell associated with benign or malignant.”

“Every treatment we can deliver in medicine-so we’ll talk specifically about surgical treatment- has some expected, immediate, and delayed side effects, and then there are some idiosyncratic side effects that don’t occur in everybody, and some complications that don’t occur in everybody that can lead to more side effects.”

“There is not a known test, or imaging study to do to predict the potential for a benign tumor to transform into a malignant tumor in the parotid gland.”

“Do I think the recurrence rates are going up? No, I don’t. There is no evidence for that right now. In fact, I think they have gotten better over the past several decades, but it remains to be seen what the new style of partial parotidectomy, and new enthusiasm for that does to recurrence rates.”

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

The pathology of a parotid tumor is a critical component in determining the proper diagnosis, treatment, and management of parotid tumors. Patients rarely get the opportunity to learn about all the work that goes on behind the scenes by pathologists as they try to properly identify and classify parotid tumors.

In this episode, Dr. Joaquin Garcia, a Professor of Laboratory Medicine & Pathology at the Mayo Clinic in Rochester, Minnesota joins us to provide us with a comprehensive overview of what happens once a pathologist receives a parotid tissue sample, and how they ultimately arrive at the final diagnosis that patients will see in their pathology reports.

Dr. Garcia will explain the different types of pathology, the challenges of identifying and classifying parotid tumors, the reasons there are so many parotid tumor types, information contained in pathology reports, and much more!

Listen in for valuable insights from Dr. Garcia!

Key Talking Points of the Episode:

• The number of parotid tumor types
  
  
• Reasons parotid tumors can be difficult to identify and classify
  
  
• Process of reviewing parotid tissue samples
  
  
• Most common benign and malignant parotid tumors
  
  
• FNA, Frozen Section Pathology, and Final Pathology
  
  
• Understanding pathology reports

Key Quotes from the Episode:

“Making the distinction between benign and malignant in parotid gland tumors often requires you understanding the entire context; how that tumor relates to its normal surroundings.”

“The pleomorphic adenoma, we think, we suspect, that as much as 10% of those tumors that if you sit on them, let them smolder, can undergo malignant transformation; turn into cancer.”

“What I am trying to get intra-operatively with frozen section pathology is I am trying to get the intra-operative management right. So, I don’t want to inspire my surgical colleagues to do too much, and I don’t want to inspire them to do too little.”

“It comes down to experience. You want to make sure your pathologist has a lot of experience with salivary gland tumors.”

“We absolutely have to get the management correct to give our patients the best opportunity to be successful in their lives.

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

Many patients have questions or concerns about general anesthesia. Understanding the process and learning about all the safety measures in place to protect patients can help alleviate some of the anxiety and fear experienced by patients as they prepare for surgery.

In this episode, Dr. Paul Warner from the Department of Anesthesia and Perioperative Medicine at the Mayo Clinic in Rochester, Minnesota joins us to address some of the common concerns that patients have about general anesthesia.

Dr. Warner will explain how the process works, discuss common side effects of anesthesia, and he will provide some tips on things patients can do to help alleviate their stress and anxiety before going into the operating room.

Listen in for valuable insights from Dr. Warner!

Key Talking Points of the Episode:

● Different levels of sedation and consciousness during anesthesia

● Patient safety during anesthesia

● Eating or drinking before anesthesia

● Medication and supplements before surgery

● Common side effects of anesthesia

● Alleviating fear and anxiety before anesthesia

● Temporary post-surgical hair loss and anesthesia


Key Quotes from the Episode:

“What Anesthesiologists do as their primary job is to keep patients safe during their procedural context or their surgical context.”

“We are always trying to prevent nausea to the very, very best of our ability.”

“When we talk about anesthesia awareness, during general or full anesthesia, it is extremely rare for people to have true awareness during the actual anesthetic.”

“We have any number of different medications or strategies to help with alleviating anxiety before people go into the operating room.”

“My strongest advice to anyone who is concerned about anesthesia is to talk with their surgeon and have the surgeon arrange a pre-anesthesia medical evaluation with an Anesthesiologist.

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

There are many elements of the surgical plan that patients must discuss with their surgeons. The goals for surgery are to completely remove the tumor, take steps to ensure that it does not spread or return, and to minimize the surgical impact on the patient.

Due to the location of the parotid gland, the surgery is performed on a highly visible area. This concerns many patients who wonder what their face will look like after surgery. Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins us again to continue our discussion about parotid surgery.

Dr. Moore will address the different reconstruction techniques with their pros and cons, side effects of reconstruction, side effects of parotid surgery, length of parotid surgery, travel considerations, and much more.

Are you ready to learn? This episode is for you.

Key Talking Points of the Episode:

• The different techniques of parotid reconstruction
• Common side effects of parotid reconstruction
• Frey’s Syndrome and reconstruction
• Side effects of parotid surgery
• Understanding clear margins
• Facial nerve repair
• Traveling for surgery

Key Quotes from the Episode:

“For the patient and the surgeon to share a like view of what’s going to happen after the surgery, and what things are going to look like, and what the desires are is very important.”

“The advice for patients, who have parotid tumors, overwhelmingly is to get them treated because ignoring them, letting them sit, not taking care of them, I think is far more dangerous than taking care of them.”

"The fear is real, and it does really influence people's decisions and makes it very difficult for them to sometimes follow through with care. But the alternative has a lot of problems associated with it that are actually more risky."

“The take home message is that done well parotid surgery is extremely safe and goes well almost all of the time.”

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.

The primary treatment for both benign and malignant tumors is surgery. The one thing that the vast majority of parotid patients have in common is the fear and anxiety that they feel before surgery. The waiting and worrying before surgery is often the worst part of the process.

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me and we’ll be talking about different aspects of parotid surgery. Dr. Moore will be sharing important information that will help prepare patients for surgery, so they can make informed decision about their medical care and mentally prepare for what lies ahead of them.

Listen in as Dr. Moore shares his knowledge, wisdom, and experiences with us.

Key Talking Points of the Episode:

· Parotid tumor treatment options

· Anesthesia

· Facial nerve monitoring

· Deep lobe versus superficial lobe

· Factors to consider when designing surgical plans

· Frozen section pathology

· Different types of parotid surgeries

· Different types of incisions

Key Quotes from the Episode:

“Surgical treatment is the correct treatment for almost every benign and malignant parotid tumor.”

“You want to know the pathology as much as you can accurately at the time of that operation to make good decisions.”

“If the branches are intact, then almost always they will come back and recover and work normally after a period of time.”

“Incisions are most of the time a seesaw battle between exposure and cosmetic deficit.”

“Different tumors require different levels of exposure and different incisions.”

Connect with Us:

· Parotid Patient Project

· Instagram

· Facebook

· Twitter

· Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey.