Chapter 21 - Anesthesia for parotid surgery

Summary

The paired parotid glands are the largest among the three major salivary glands in the human body. The parotid gland is encapsulated between the superficial and deep layers of the parotid gland fascia (PGF). This chapter discusses the surgical treatment and anesthesia of sialolithiasis. Airway management after parotidectomy with radical neck dissection can be a challenging situation due to aggravating factors like previous neck interventions, radiation therapy, large fluid shift, intraoperative airway manipulation, swollen tissue and residual anesthetic effect. Ductal stone formation and ductal stenosis are common causes of obstructive salivary diseases of the parotid glands. Sufficient anesthetic depth and patient immobility are usually achieved by a balanced anesthetic technique employing relatively large doses of opioid and inhalational agents. Light anesthesia and patient movement lead to serious complications, especially in the absence of neuromuscular blockade.