CPT® Code 42425

Total excision of the parotid gland or a parotid tumor involves a surgical procedure where the entire parotid gland is removed, often due to the presence of a tumor that has invaded surrounding structures, including the facial nerve. The parotid gland is the largest of the three major paired salivary glands, located beneath and in front of the ear, playing a crucial role in saliva production. The procedure can be performed in two ways: one that preserves the facial nerve and one that involves the sacrifice of the facial nerve. In cases where the tumor has not invaded the facial nerve, the surgeon can carefully dissect the gland and tumor away from the nerve, preserving its function. However, in more advanced cases, such as those described by CPT® Code 42425, the tumor has invaded the facial nerve, necessitating an en bloc removal of both the parotid gland and the tumor, which results in the sacrifice of the facial nerve. This procedure requires careful dissection and identification of the facial nerve branches to ensure that the surgical approach is as safe and effective as possible. The surgical incision is typically made in front of the ear, allowing access to the gland while minimizing visible scarring. Following the excision, measures are taken to control bleeding and ensure proper healing, including the placement of a drain to prevent fluid accumulation.