TUMOR SURGERY OF THE FACE – No Visible Scars

Nicole Poole is happy, upbeat, the kind of woman who laughs and smiles a lot. Her personality jibes with her business (she runs a nail shop out of her South Side Chicago home), but it’s also her nature. In 2013, the face that holds Poole’s frequent smiles and laughs starting growing. Very fast. One morning she woke up and felt a bump on the right side of her face, then before too long the growth exploded. “Everything just kind of started happening,” Poole, 45, recalled. While she didn’t feel any pain from the growth, it kept getting larger by the day, expanding both on her face, by her right earlobe, and inside her face.

“It was firm. You could press into it, like a grape or a plum,” she said. Her customers, including some who work in healthcare, were concerned, and started doing research on her behalf, while Poole first consulted her dentist, then her primary care doctor. “’Nicki, what’s going on?’” her customers and friends would say, Poole recalled. Then she was referred to UI ENT and Tatiana Dixon, M.D. The two hit it off right away. Dr. Dixon, according to Poole, instantly reassured her because she “immediately knew what it was,” even before formal tests and scans. Poole’s growth was a parotid gland tumor, one that developed in the largest of the salivary glands. Dr. Dixon recommended removing it, because tumors like Poole’s can grow and keep growing. “You can bleed into [these tumors],” Dr. Dixon said. “That causes them to keep expanding” and can add to the patient’s discomfort, she noted.

Another risk, Dr. Dixon explained, was the possibility of paralysis if the tumor continued to grow. Paralysis was also a potential risk of the surgery itself, because it requires great intricacy and dexterity not only to remove a growth that large, but to manipulate facial nerves to do the surgery properly and safely without damage to them. “No one wants to hear about paralysis,” Poole said. When she heard there was a chance she would lose some of the feeling in the affected area, the optimist in her said, “what can you do? I knew Dr. Dixon was a good doctor,” she remembered. “She wasn’t stressing…so I was good.” Such growths, while relatively rare, can come from multiple sources. And while surgery initially was arranged after a few visits to Dr. Dixon, a more urgent condition arose during pre-operative tests. Poole was diagnosed with hypertension, something that needed to be addressed and controlled before she could have the surgery. “If it hadn’t been for this thing, I probably wouldn’t have learned about my high blood pressure,” Poole remembered.

Once that condition was under control, she returned a few months later for the surgery. Fine-needle aspiration was unable to diagnose what type of tumor Poole had, and subsequent pointed toward a benign lesion, Dr. Dixon said. Yet when she performed the surgery last May, removing a tumor that was the size of an orange, she identified a low-grade cancer, one that almost certainly preceded the growth. (Some salivary gland tumors are caused by cancers). In essence, Dr. Dixon said, the surgery itself not only treated the parotid tumor, it removed the cancer. Hearing the news about the cancer shocked Poole at first. “I wasn’t expecting it. I was initially scared,” she said. But Dr. Dixon was confident the cancer was gone, and sees Poole every few months to monitor her condition, which is excellent.

Poole’s face and nerve function are normal now, nearly a year after the surgery, and notes people have to look hard at her right side to notice the scar. “Some people who saw me with the tumor say Dr. Dixon did a really good job,” she said For Dr. Dixon’s part, Poole is a great patient. “It’s not easy getting a cancer diagnosis, even after the surgery. But Nicole has had a great sense of humor throughout this process,” she added. “She’s a very nice woman. She took good care of herself and had a great positive attitude from the very beginning.” And Poole, ever upbeat, has her smiling face back. “Everything is the way it should be,” she said.