MY PAROTID JOURNEY
History
‘82, age 4
Bell’s Palsy, Briefly
14 years on … age 16
Bell’s Palsy, possibly stress induced during exams
40 years on … age 43
Visited GP (in training), end ‘22 about lump causing bit of pain, thought salivary stones, took bloods - all fine, pain eased
41 years on … age 44
Returned to GP, end ‘23 as lump had grown, again took bloods, all fine but referring on …
2 Weeks On … 3 Jan
Maxillofacial surgeon, Terry Lowe
Aberdeen Royal Infirmary
Clinical assessment, Ultrasound & FNA
(nearly fainted)
3 Weeks On … 11 Jan
Lowe called to say FNA shows suspected Benign Pleomorphic Adenoma (PA)
4 Weeks On … 25 Jan
MRI (1.5 scanner)
10 Weeks On … 6 Mar
Lowe called to say MRI matches FNA - suspected PA
Recommended surgery as grows slowly, small chance turning malignant both making surgery harder & risker, 1in100 ‘stroke’ like symptoms post op
Approx. 2/3 month wait, cancer patients 1st, agreed to go on …
Parotidectomy
Removes one or both parotid glands, that produce almost half of saliva. There are 2 facial nerves on either side of face, each runs through the parotid gland, separating the shallow part from the part deeper from surface of face.
Sometimes a lump can form in the gland. Your healthcare team have suggested a parotidectomy, however it's your decision to go ahead or not.
Complications include:
Facial Nerve Weakness - 20% Temp, 1% Perm
Numbness, possibly permanent
Sialocele (saliva lump) - 2-5%
Fistula (leaking saliva from wound) - 6%
Frey’s (redness, pain & sweating when eat) - 1%
Recurrence - 2%
8 Months On … 7 Aug
Pre-op (with 1 week notice)
Tests, Questionnaire
Given leaflet stating -
Found Extracapsular Dissection (ECD)
When researching Parotidectomy, discovered ECD - bespoke precise specialised method to remove benign parotid tumours whilst preserving the gland, completely different to traditional parotidectomy, leading to less complications and significantly lessen risk of injury to facial nerve.
ECD
Hologram
This is truly a surgery for the future.
Investigate Feasibility
Add hologram example
The eligibility is not so much size but only benign tumours.
You need the extended form, allowing access to deep lobe tumours. I doubt if anyone is using it in Scotland. You may get permission to come London if you report you can’t get this operation in Scotland.
In my hands op lasted about 2-3 hrs, patients stayed in 1 night, temp injury rate was 6-8% but the related to size and position of lump.
UCLH is the only team that can turn MRI scans into a 3D picture showing position of nerve. If you want a model then you need an MRI scan with one of the new 3 Tesla scanners. I can vouch for Mr Sahovaler as we operated together for my last 18 months doing parotid surgery.
Professor Mark McGurk, UK ECD Pioneer (Retired, June 2024)
Gg8 Aug … Enquire in about ECD
Called ARI, Lowe advised ECD not possible on my tumour & schedules face-face meeting for 4 Sep
Found Extracapsular Dissection (ECD)
When researching Parotidectomy, discovered ECD - bespoke precise specialised method to remove benign parotid tumours whilst preserving the gland, completely different to traditional parotidectomy, leading to less complications and significantly lessen risk of injury to facial nerve.
ECD
Hologram
This is truly a surgery for the future.
Investigate Feasibility
Add hologram example
The eligibility is not so much size but only benign tumours.
You need the extended form, allowing access to deep lobe tumours. I doubt if anyone is using it in Scotland. You may get permission to come London if you report you can’t get this operation in Scotland.
In my hands op lasted about 2-3 hrs, patients stayed in 1 night, temp injury rate was 6-8% but the related to size and position of lump.
UCLH is the only team that can turn MRI scans into a 3D picture showing position of nerve. If you want a model then you need an MRI scan with one of the new 3 Tesla scanners. I can vouch for Mr Sahovaler as we operated together for my last 18 months doing parotid surgery.
Professor Mark McGurk, UK ECD Pioneer (Retired, June 2024)
Gg8 Aug … Enquire in about ECD
Called ARI, Lowe advised ECD not possible on my tumour & schedules face-face meeting for 4 Sep
