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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2010 August;21(2):71-6
Parotid surgery: comparison of reconstructive techniques
De Maria G. 1, Graziano P. 1, Abbate V. 1, Pavone E. 2, Dell’ Aversana Orabona G. 1, Califano L. 1
1 Division of Maxillo-Facial Surgery, Federico II University of Naples, Naples, Italy
2 G. Pascale National Cancer Institute, Naples, Italy
Aim. After parotidectomy many patients have complications such as Frey’s syndrome and depression in pre and sub-auricular region. In literature several reconstructive techniques were proposed to prevent them.
Methods. We aimed the present prospective study to compare three different reconstructive techniques through the postoperative evaluation of skin depression, Frey’s syndrome and hematomas. Between May 2005 and March 2008 we selected for this study 45 patients with benign tumor of parotid gland operated at the Department of Maxillofacial Surgery in the University Federico II of Naples. The sample was divided randomly into three groups depending on the type of reconstruction done: 15 with sternocleidomastoid rotational flap (SCM) flap, 15 with the subsuperficial musculoaponeurotic system elevation of skin flap (SMAS) technique and 15 with temporoparietal fascia rotational flap (TPF) flap.
Results. From an analysis of literature and the data obtained after 18 months of postoperative observations, we have gained the indications and complications for each of the techniques we performed. We suggest the SMAS as the technique of first choice in superficial parotidectomy. Alternatively, in patients with thin subcutaneous tissue, we prefer the use of SCM flap.
Conclusion. We discouraged the use of TPF flap in superficial parotidectomy however we propose this technique to rebuilt the area after total parotidectomy.