PAROTID LUMPS
A lump in front of or below the ear is usually located within the parotid gland, the largest of the salivary glands. Most parotid lumps are benign, but they require thorough assessment and, in most cases, surgical removal — both to confirm the diagnosis and to prevent further growth or, in rare cases, malignant change. Mr Oliver Dale is a Consultant Head & Neck Surgeon in Bristol with fellowship training in advanced head and neck surgery, offering private parotid surgery with facial nerve monitoring as standard. He specialises in minimal access parotid surgery aiming to reduce visible scarring and improve the speed of recovery.
PAROTID LUMPS
WHAT CAUSES A PAROTID LUMP?
The great majority (around 80%) of parotid lumps are benign tumours, most commonly a pleomorphic adenoma or Warthin's tumour. A smaller proportion are cancerous. In some cases parotid swellings are caused by stones or infection resulting in a diffuse enlargement of the parotid gland. As these causes cannot be reliably distinguished by examination alone, every parotid lump warrants thorough investigation.
HOW ARE PAROTID LUMPS DIAGNOSED?
Diagnosis begins with a detailed history and examination of the head and neck, followed by an ultrasound scan, often combined with a fine needle aspiration — a small needle sample of cells taken from the lump and analysed under the microscope. In some cases, an MRI or CT scan is also arranged to provide a clearer picture of the lump's size and position, particularly where it lies close to the facial nerve.
PRIVATE PAROTID SURGERY IN BRISTOL
WHAT HAPPENS DURING SURGERY?
Surgery to remove a parotid lump is known as a parotidectomy, and involves removing either part of the gland (a partial or superficial parotidectomy) or the whole gland (a total parotidectomy), depending on the size and position of the lump. It is performed under general anaesthetic through an incision positioned just in front of the ear, curving behind the earlobe and into the upper neck — similar in position to a facelift incision, and one that heals discreetly.
The facial nerve, which controls movement of the face, runs directly through the parotid gland, so identifying and protecting it is central to the operation. Mr Dale uses intraoperative nerve monitoring and magnification as standard for this reason. A small drain is typically placed at the end of surgery and removed the following day, with most patients remaining in hospital overnight.
RISKS AND POSSIBLE COMPLICATIONS
The overall risk from parotid surgery is low, but it is important to approach surgery with a full understanding of the possible complications, all of which Mr Dale will discuss in detail at your consultation. Parotid tumours usually lie on the facial nerve (the nerve that controls facial movement). As a result, facial weakness occurs in around 15% of cases, but this usually fully resolves within a few weeks to months; permanent weakness is rare in benign disease. Numbness of the ear lobe and surrounding skin is common, most noticeable when wearing earrings or shaving, and typically improves with time. A slight hollowing of the cheek may be noticeable where the gland or lump has been removed — usually mild, and treatable should it become bothersome. Frey's syndrome, characterised by sweating or flushing of the cheek skin when eating, can develop some months after surgery and is generally managed with an antiperspirant. Bleeding, or an accumulation of saliva beneath the skin, occurs occasionally and may require a further short procedure to resolve.
RECOVERY
Most patients stay in hospital overnight for observation. The drain will be removed the day after surgery before discharge. Practical guidance for the days after surgery:
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The wound is closed with dissolvable sutures beneath the skin — there's nothing to have removed, and a dressing or steri-strips are usually left in place for the first few days
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Keep the wound clean and dry initially; most patients can shower normally after 48 hours
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Contact the ward at The Spire Hospital Bristol if you notice increasing swelling, difficulty breathing, or spreading redness around the wound
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Once healed, gentle scar massage or a silicone gel, can help the scar settle
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A follow-up appointment is arranged 4 weeks post-operatively to review the pathology results.
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Most people manage light activity within a few days and return to non-strenuous work within 1-2 weeks
FEES
Private parotidectomy fees typically depend on whether a partial or total parotidectomy is required and on the overnight hospital stay, in addition to a separate consultation fee (usually £275-£300). A full, itemised quote covering surgeon, hospital and anaesthetist fees is provided after your consultation and any scans.
TRAVELLING FOR TREATMENT
Mr Dale is a highly experienced parotid surgeon offering treatment for complex and recurrent parotid tumours. As a result, people travel from across the UK for treatment. The Spire Hospital, Bristol is easily reached from South Wales, the Midlands and London via the M4/M5 and direct trains to Bristol Temple Meads.
FREQUENTLY ASKED QUESTIONS
Is a parotid lump usually cancer?
No — around 80% of parotid tumours are benign. However, only thorough assessment (ultrasound, FNA, and sometimes MRI) and, usually, surgical removal can confirm this with certainty.
Will I be left with a visible scar?
The incision is positioned in the natural skin creases in front of and behind the ear, in a very similar line to a facelift incision, and typically heals discreetly.
How long will I be in hospital?
Most patients stay one night, with the surgical drain removed the following morning.
What is facial nerve monitoring?
It's a technique used during surgery to help identify and protect the facial nerve, which runs through the parotid gland and controls movement of the face. Mr Dale uses this as standard for parotid surgery.
How soon can I be seen?
Private consultations are typically available within 1-2 weeks, with surgery arranged shortly after your assessment and any scans.
Does private medical insurance cover parotid surgery?
Most insurers cover parotid surgery, particularly when there's a lump requiring investigation. Mr Dale's secretary can help confirm cover with your insurer, or provide a self-pay quote.
WHAT PATIENTS SAY...
I honestly cannot thank Mr Oliver Dale enough for the care and support he gave me during such a worrying time. After finding a lump on my parotid gland I was extremely anxious and frightened, and my mind immediately went to the worst possible scenarios. From the moment I was seen by Mr Dale he made me feel completely at ease.
APPOINTMENTS
Mr Dale offers private appointments at The Spire Hospital in Bristol.
To book an appointment call Mr Dale’s private secretary on 0117 287 0148 or email secretary@bristolentsurgery.co.uk
Alternatively, you can contact Mr Dale's secretary using the form below: