Early reexploration of the parotid wound following parotidectomy

Our experience with reexploration of the parotid wound following parotid gland surgery is presented. There is scant information in the literature to guide the head and neck surgeon in deciding when, and indeed whether, he can safely reexplore the parotid wound following parotidectomy for the removal of residual disease or for determination of neural integrity. The authors treated six patients at Stanford University (Stanford, CA), all of whom underwent reexploration of the parotid wound. Four patients were reexplored to remove residual disease, and two patients were reexplored to evaluate the integrity of the facial nerve after evidence of neural degeneration. Reexploration was undertaken from seven to 23 days after the primary surgical procedure. In all cases, no difficulty was encountered in identification and repair of the facial nerve or removal of residual disease. Five of these patients have fully recovered facial nerve function; one is awaiting recovery after a facial nerve grafting procedure. We recommend early reexploration of the parotid wound following parotidectomy for the removal of residual disease and to assess the integrity of the facial nerve in instances of neural degeneration. Reexploration may be easily and safely accomplished within 3 weeks of initial surgery without significant risk of further neural damage.