At the Institute, Dr. Osborne and Dr. Hamilton perform all of your surgeries, meaning that a head and neck oncologist performs your tumor removal and a facial plastic surgeon performs your wound closure and reconstruction. No residents, physician assistants, or medical students perform any part of your procedure, which is commonplace at many teaching hospitals and universities.

• Bipedicled Sternocleidomastoid (SCM) Muscle Flap
• Parotidectomy Trans-Oral Removal
• Parotidectomy Mini-Incision™
• Parotidectomy and Revision Surgery
• Sialendoscopy for Salivary Gland Stones
• Plastic & Reconstructive Surgery
• Correction of Parotid Facial Deformities
• Facial Nerve Monitoring

Bipedicled Sternocleidomastoid (SCM) Muscle Flap

Removal of a parotid tumor requires removal of a margin of normal tissue around the tumor as well to prevent regrowth. Unfortunately, this results in an increase in the volume of tissue removed from the face, leaving a "sunken" appearance. The bipedicled SCM muscle flap was designed to fill in the facial defect left by the tumor removal, restore facial symmetry, and maintain facial fullness.

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Parotidectomy Trans-Oral Removal

Accessory parotid gland tumors are located in difficult to reach areas of the face. Typically, long facial incisions are used to gain access. This approach leaves scarring and facial contour deformities. The trans-oral approach eliminates all facial incisions, resulting in no scars. In addition, the trans-oral approach dramatically reduces the duration of surgery.

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Parotidectomy Mini-Incision™

The facial nerve is only a few millimeters wide and is the most important structure to identify when performing parotid surgery. Incisions that extend up to the hair line and far down into the neck do nothing to improve exposure of the nerve. Long incisions simply add increased swelling, cause slower healing, and increase the risk of scarring. We perform a safer surgery through a smaller incision.

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Parotidectomy and Revision Surgery

Unfortunately, some parotid tumors regrow after initial treatment, requiring further surgery. Repeat surgery increases both the chances of facial paralysis and facial cosmetic deformities. We specialize in removing recurrent tumors while maintaining facial nerve function and facial symmetry.

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Sialendoscopy for Salivary Gland Stones

Parotid gland swelling and inflammation secondary to salivary stones can now be treated with minimally invasive techniques. The standard treatment for obstructive salivary gland stones is a total parotidectomy. Sialendoscopy allows these obstructive stones, which are causing the gland to be swollen, to be removed non-surgically, avoiding the standard risk associated with parotidectomy such as facial nerve paralysis and facial deformity.

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Plastic & Reconstructive Surgery

Patients with benign tumors may be candidates for facial rejuvenation procedures in combination with their parotid surgery. Standard parotid surgery often leaves patients with facial irregularities secondary to skin expansion and stretching caused by the growing tumor. After tumor removal, the soft tissues of the cheek and overlying skin may be sagging, lax, and redundant,and may require sculpting to successfully reconstruct this facial area. This laxity may be more pronounced in aging women and men, or patients with larger tumors. To improve overall harmony to the face, it may be beneficial for some patients to combine other rejuvenation procedures with their primary surgery to comprehensively enhance their facial appearance. Dr. Hamilton has dual training in head and neck surgery as well as facial plastic and reconstructive surgery, making it possible, when appropriate, to restore form and function while simultaneously improving one's appearance.

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Correction of Parotid Facial Deformities

Advances in facial augmentation with temporary and semi-permanent soft tissue fillers make it possible to improve the appearance of unsightly scars and facial asymmetries without the need for permanent implants or surgery. Candidates for these treatments generally have good facial symmetry with only minor scarring or facial deformities. Patients who have had multiple surgeries and desire less invasive procedures to improve their appearance may also find these treatments appealing. These procedures are performed on an outpatient basis and require little to no down time.

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Facial Nerve Monitoring

Perhaps the most frightening aspect of parotid surgery is the risk of injury to the facial nerve resulting in facial paralysis. Although there is no substitute for surgical experience and understanding of the anatomy to minimize surgical risk to the facial nerve, intra-operative nerve monitoring is very useful. A special device is used to monitor the facial nerve much like a car alarm. When the nerve is stimulated the "alarm rings" signaling the surgeon and thus reducing the chance of injury to the facial nerve. All parotid surgery at the Institute is performed with facial nerve stimulation and/or monitoring in place.