OBJECTIVES: We sought to study the incidence of patient-initiated communication after parotidectomy, identify patient and surgical factors associated with patient-initiated communication, and evaluate trends and possible areas for improvement. METHODS: A retrospective cohort study of patients who underwent parotidectomy without combined procedures from 2018 to 2022 in a single tertiary-care institution was performed. We reviewed all patient communications documented within the electronic medical record within 30 days of discharge. We categorized patient communications as requiring an action by the surgeon, instruction by support staff, or reassurance. RESULTS: A total of 363 patients were included. Most patients were women (55.4%), Caucasian (78.8%), and had an average age of 56 years ± 16. We found 123 (33.9%) patients initiated postoperative communications. Swelling (47.2%) was the most common concern followed by wound concerns (15.4%). Switching from planned inpatient to outpatient surgery increased (OR = 2.635
95% CI = 1.200-6.146, p = 0.026) propensity for postoperative communication. We found 31 (25.2%) postoperative communications required an action by the surgeon, 40 (32.5%) required instruction by the support staff, and the other 52 (42.3%) required reassurance or clarification. Multivariate analysis showed swelling (OR = 6.5, CI = 2.2-19, p <
0.001), male sex (OR = 3.27, CI = 1.127-9.459, p = 0.029), previous smoking (OR = 3.468, CI = 1.181-10.185, p = 0.024), and cancer (OR = 6.862, CI = 1.757-26.804, p = 0.006) were predictive of requiring an action by the surgeon. CONCLUSIONS: This is the first study to evaluate patient-initiated communication after parotidectomy and found it occurred 33.4% of the time. We found significant opportunities to improve perioperative care, enhance patient satisfaction, and reduce the overall burden on medical personnel. LEVEL OF EVIDENCE: 4 Laryngoscope, 135:1105-1112, 2025.