DATE: @TD@
PATIENT NAME: @NAME@ 


PREOPERATIVE DIAGNOSIS: 
***

POSTOPERATIVE DIAGNOSIS: 
Same

OPERATION: 
***

SURGEON: William Morrel, MD 

ANESTHESIA: General 

INDICATIONS FOR PROCEDURE:  
***

FINDINGS:  
***

DESCRIPTION OF PROCEDURE

After informed consent had been obtained, the patient was brought to the operating room and general anesthesia was induced. The patient was intubated and the bed was turned 180 degrees. Bipolar facial nerve monitoring electrodes were inserted into the orbicularis oris and orbicularis oculi muscles, and the grounding electrodes were inserted into the shoulder. A modified-Blair preauricular incision was marked out extending into a neck crease on the *** side. The planned incision was marked on either side with methylene blue using an 18 gauge needle and was injected with *** mL of 1% lidocaine with 1:100,000 epinephrine. The patient was prepped with Betadine and draped in the standard fashion. 

A surgical time-out was performed. A preauricular incision extending into a neck crease was made on the ***. A sub-platysmal and sub-SMAS flap was raised. Dura hooks were used to maintain visualization. The parotid was lifted of the sternocleidomastoid and external auditory canal. The digastric was identified and traced to the mastoid. The styloid was identified. The tissue at the stylomastoid foramen was sharply dissected and the main trunk of the facial nerve was identified. The facial nerve was traced to the pes and then each individual branch was dissected such that the entire superficial parotid was excised. This was sent as a permanent specimen.

The surgical site was irrigated and hemostasis obtained. A 10 French round drain was placed, brought out posterior to the incision, and sutured in place. The remaining parotid fascia was sutured to the SCM with 3-0 Vicryl to prevent Frey's syndrome. The platysma was closed with 3-0 Vicryl. The skin of the neck was closed with 4-0 Vicryl. The skin of the face was closed with 4-0 Monocryl. Mastisol and 1/4-inch steri-strips were applied.  The facial nerve monitoring electrodes were removed. 

The patient tolerated the procedure well and was turned over to Anesthesia, awakened, and extubated. There were no acute complications.

ESTIMATED BLOOD LOSS: *** mL
 
COMPLICATIONS: None ***

SPECIMENS: ***

DISPOSITION:
The patient was transferred to the recovery room in stable condition.