Lake County ENT/Head & Neck Specialists Phone (847) 662-4442 Fax (847) 662-4446 Post-operative Instructions following Parotidectomy General: The parotid gland is a large, saliva producing gland found deep to the cheek skin, extending from the area just in front of each ear to just below each ear. Both parotid glands have a small duct that collects saliva from the gland and transmits it to the mouth through a small opening on the inside of each cheek. Parotidectomy or partial parotidectomy is performed to remove malignant and benign tumors or cysts of the parotid gland. On rare occasion, parotidectomy is undertaken to remove an irreversibly inflamed or diseased parotid gland. This surgery is performed through an incision that extends from the front of each ear, around the angle of the jaw, to the upper neck skin. This is performed under general anesthesia and you may be hospitalized for one night following your procedure. At the time of surgery, a small drainage tube may be placed in the upper neck (under your earlobe) to prevent accumulation of blood and fluid under the skin. The drain is usually removed the day after surgery. You should avoid non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen (Excedrin, Motrin, Naprosyn, Advil) for 10 days prior to the surgery. These drugs are mild blood thinners and will increase your chances of bleeding. Diet: Unless otherwise directed, you may have liquids by mouth once you have awakened from anesthesia. If you tolerate the liquids without significant nausea or vomiting then you may take solid foods without restrictions. Pain Control: Patients report moderate facial and neck pain for several days following parotidectomy. This is usually well controlled with prescription strength oral pain medications. Please take the pain medication prescribed by your surgeon when needed. You should avoid non- steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen (Excedrin®, Motrin®, Naprosyn®, Advil®) because these drugs are mild blood thinners and will increase your chance of having a post-operative bleed into the facial or neck tissues. Activity: Sleep with the head elevated for the first 48 hours. You may use two pillows to do this or sleep in a reclining chair. Gentle rotation, flexion and extension of the head and neck is permitted. No heavy lifting or straining for 2 weeks following the surgery. You should plan for 1 week away from work. If your job requires manual labor, lifting or straining then you should be out of work for 2 weeks or limited to light duty for 2 weeks. (Continued Æ)
Wound Care: Do not wash or manipulate the neck wound for 48 hours following the surgery (except to apply Vaseline). The neck dressing (if applied) will be removed on the morning following your surgery. The skin has been closed with sutures that will be removed at your follow-up appointment. Mild redness and swelling around the wound is normal and will decrease over the 2 weeks following surgery. If a drain has been placed, it will be removed the day after surgery. Once you are home, apply a thin layer of Vaseline to the wound 3 times daily. You may shower and allow the wound to get wet 48 hours following the surgery. Allow soap and water to run over the wound. Do not scrub or manipulate the wound for 7 days. Pat the area dry; don’t rub it with a towel. After 7 days you may gently lather the wound with soap and water. Follow-up Appointment: Your follow-up appointment in the office will be 5-8 days following your surgery. At the post- operative visit the pathology report is reviewed and your sutures are removed.
University of Michigan Guidelines for Health System Clinical Care Gastroesophageal Reflux Disease (GERD) Patient population: Adults Guideline Team Objective: To implement a cost-effective and evidence-based strategy for the diagnosis and Team Leader treatment of gastroesophageal reflux disease (GERD). Joel J Heidelbaugh, MD Family Medicine Key Points:
Antimalarial activity of methanolic extracts from plants used in Kenyan ethnomedicine and their interactions with chloroquine (CQ) against a CQ-tolerant rodent parasite, in mice. Francis W. Muregia,c,* , Akira Ishiha , Toshio Miyaseb , Tohru Suzukia , Hideto Kinoa , Teruaki Amanod , Gerald M. Mkojic , Mamoru Teradaa aDepartment of Parasitology, Hamamatsu University School of Medicine, 1-