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Meet Dr. Larian

Dr. Babak Larian, the Chairman and Director of the CENTER for Advanced Parotid Surgery in Los Angeles, is a highly experienced and reputable board-certified surgeon...
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  • 6 Little-Known Facts About Parotid Tumors How Expert Surgeons Perform Parotid Reconstruction
    If your parotid gland function has been impaired for any reason, such as a parotid tumor, you may need surgery. Read more >

Deep Lobe Parotid Tumor Removal

Parapharyngeal tumor-vesselsDeep Lobe Parotid Tumor Removal

A deep lobe parotid tumor presents a unique set of considerations as the tumor is near delicate structures of the head and neck. The parotid gland is comprised of two lobes known as the superficial lobe and the deep lobe. These two sections of the parotid gland are separated by the facial nerve, making parotid surgery a complex procedure. Dr. Babak Larian of the CENTER for Advanced Parotid Surgery is world-renowned for his parotid surgery expertise and is an innovator in the field of minimally invasive parotid surgery.

Deep lobe parotid tumors are located in the parapharyngeal space in the neck. The parapharyngeal space is located below the skull and contains many important structures such as the Carotid artery, Jugular vein, Vagus nerve, Hypoglossal nerve, Glossopharyngeal nerve, parotid gland, minor salivary glands, lymph nodes, and many other nerves. Because of the delicate, yet complex nature of these structures, it is crucial that you visit a highly trained, experienced parotid gland surgeon for deep lobe parotid tumor removal.

Deep Lobe Tumor Removal Procedure

Deep lobe tumor Dr. Larian always performs parotid surgery with a team of highly trained experts to ensure the safety of the surrounding structures is maintained. The size and exact location of the deep lobe tumor will dictate the size of the incision necessary, although our team of experts always uses the least invasive method possible for parotid tumor removal. Due to the fact that the tumor is usually deep to the mandible (lower jaw), the incision is usually placed on the neck just below the mandible. This allows Dr. Larian to look from bottom up under the mandible and therefor be able to see the tumor.

At first, during the surgery the nerves and blood vessels are identified, and dissected and traced all the way up to the base of skull. By identifying the important structures first you can improve the surgical Parapharyngeal Tumor Incisionoutcome. Usually the incision below the jawline measures just over an inch, and is hidden in a skin crease. In all cases, we prepare the patient for the possibility of having to extend the incision superiorly and go in front of the ear, as in a traditional parotidectomy incision, just in case the facial nerve needs to be dissected out so that we can have access to the top part of the tumor; this very rarely done and is reserved for those cases when there is very little space between the tumor and the under surface of the skull. Dr. Larian can better asses this possibility once he has examined you and seen the MRI. In these tupes of cases, he works with Babak Azizzadeh, MD, FACS, expert facial plastic and facial nerve surgeon, to ensure the deep lobe tumor is safely removed, the facial nerve and surrounding structures are not harmed, and that the area is reconstructed so that there is little evidence of surgery.

This is usually an out patient procedure, and the patients are able to eat, talk and move about on the same day as surgery. The risks of the surgery have mostly to do with what structure the tumor is involving. In cases of the deep parotid tumors that are benign, because these tumors don’t tend to involve nerves the risk of injury to the nerve is minimal, but still present. In cases of the tumors arising from the nerves, such as schwanomas, the risks have to do with which nerve is involved; if the tumor is intimately involved with the the nerve then it may not be possible to save the nerve and this would only be apparent at the time of surgery. An MRI cannot tell you if the tumor is on the side of the nerve or if it’s intertwined with the nerve. First Bite Syndrome is also a risk of surgery in the parapharyngeal space, where due to injury or irritation of the nerves, with each first bite of a meal, the patient experiences a sharp pain. Injury to blood vessels are a possibility as well, although rare. The risks discussed are much more with cancerous tumors in this area.

Why Choose the CENTER for Advanced Parotid Surgery?

It is critical that patients seeking deep lobe parotid tumor removal visit a parotid gland expert for surgery. With the facial nerve running through the parotid gland and the proximity of other structures within the parapharyngeal space, the risks are great if one does not choose an expert surgeon for deep lobe tumor removal. Dr. Larian and his team perform more parotid gland surgeries than almost any other surgical team in the country. Each member of the team is world-renowned in their specific field and they use cutting-edge surgical techniques and innovative technology for every procedure. With an expert parotid surgeon like Dr. Larian and his team of experts, you can be assured you are in the best possible hands for deep lobe parotid tumor removal.

Contact the CENTER for a Consultation Today

If you have or think you may have a deep lobe parotid tumor, contact us today. Dr. Larian would be happy to assess your condition and create a treatment plan just for you. Don’t put yourself at risk by visiting just any surgeon; reduce your risk by visiting the best. Call Dr. Larian at 888.574.0178 today to schedule a consultation and see if you are a candidate for deep lobe tumor removal.

For more information on parapharyngeal space tumors, contact our office.

Next, learn about revision parotidectomy.


Request your consultation with Dr. Larian today.
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Chief of Head & Neck Surgery at Cedars-Sinai
Assistant Clinical Professor of Surgery at UCLA