The parotid gland is the largest of the salivary glands and lies just in front of the ear, above the angle of the jaw. The great majority of salivary gland tumours develop in this gland, and most of them are benign. Because the facial nerve, which controls the movements of the face, runs through the gland, the treatment of parotid tumours requires special attention.1,2
The parotid gland and the facial nerve
The parotid gland is divided by the branches of the facial nerve into two parts, superficial and deep. Most tumours are located in the superficial part. The facial nerve controls movements such as wrinkling the forehead, closing the eye, smiling and pursing the lips. The relationship of the tumour to the nerve is therefore decisive both in diagnosis and in treatment planning.3
Symptoms
- A slowly growing lump that does not hurt, in front of the ear or below the earlobe
- A lump that becomes noticeable over months or years
- Rarely, pain, a feeling of fullness in the ear or discomfort when chewing
- Weakness on one side of the face, inability to close the eye fully or drooping of the corner of the mouth
Benign tumours usually cause nothing but a lump. Pain, rapid growth, redness of the skin or weakness of the facial nerve are warning signs of a malignant tumour.2
Diagnosis
During the examination, the size, consistency and mobility of the mass are assessed and the function of the facial nerve is checked. Ultrasound is the first imaging method; fine-needle aspiration biopsy gives preliminary information about the type of tumour. For tumours located in the deep part or suspected of being malignant, magnetic resonance imaging (MRI) shows the borders of the tumour and its relationship to the nerve. The definite diagnosis is made by pathological examination of the tissue removed at surgery.1,2
Treatment
The treatment of parotid tumours is surgical; the operation is called a parotidectomy. In benign, superficially located tumours, the superficial part of the gland is removed together with the tumour (superficial parotidectomy). In deep-seated or malignant tumours, the whole gland may be removed (total parotidectomy). In both cases the facial nerve and its branches are identified and exposed, and are preserved unless the tumour involves them; a nerve monitoring device (neuromonitor) may be used during the operation. In malignant tumours, removal of the lymph nodes of the neck and radiotherapy may be needed depending on the pathology result.2,3,4
After surgery
The incision is usually made along a line that starts in front of the ear and extends to the upper part of the neck, following the natural creases. Mild swelling and tenderness for a few days after surgery are normal. Temporary weakness of the facial nerve may occur; when the nerve has been preserved, this weakness usually resolves within weeks or months. Numbness around the earlobe is common and usually decreases with time. Some people develop sweating or flushing over the operated area while eating (Frey’s syndrome); this is usually mild and can be treated if necessary.1,4
When should you see a doctor?
If you notice a persistent lump in front of the ear, a growing or painful mass, or weakness on one side of your face, it is advisable to seek an evaluation.
Frequently asked questions
Does parotid tumour surgery cause facial paralysis?
Because the facial nerve runs through the gland, the operation aims to preserve it; temporary weakness may occur and usually improves with time; permanent weakness is less common, and permanent weakness of the whole face is rare.
Can a parotid tumour be diagnosed definitively with a needle biopsy?
Fine-needle biopsy gives a strong preliminary indication of whether the tumour is benign or malignant; the definite diagnosis is made by examining the tissue removed at surgery.
Will I have a dry mouth after surgery?
Because the other salivary glands continue to work, removal of one parotid gland does not usually cause noticeable dry mouth.
Related articles
- Will I get facial paralysis after salivary gland surgery?Why the facial nerve is at risk in parotid surgery, how often weakness happens in published figures, how the nerve is protected and how the eye is cared for.
- Why does a salivary gland swell?A stone, an infection or a tumour? The main causes of a swollen salivary gland, how they differ, how the cause is found and when to see a doctor.
References
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ENT UK. Parotidectomy – surgery to remove a lump [Internet]. London: ENT UK; 2023 Aug 24 [cited 2026 Oct 5]. Available from: entuk.org ↩
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Sood S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S142-S149. doi:10.1017/S0022215116000566 ↩
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Cancer Research UK. Types of surgery for salivary gland cancer [Internet]. London: Cancer Research UK; [reviewed 2026 May 7; cited 2026 Oct 5]. Available from: cancerresearchuk.org ↩
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Eren SB, Dogan R, Ozturan O, Veyseller B, Hafiz AM. How deleterious is facial nerve dissection for the facial nerve in parotid surgery: an electrophysiological evaluation. J Craniofac Surg. 2017;28(1):56-60. doi:10.1097/SCS.0000000000003186 ↩
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.