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Related Experiment Videos

Functional outcome after total parotidectomy reconstruction.

Willard E Fee1, Lynn E Tran

  • 1Division of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA, USA. wfee@stanford.edu

The Laryngoscope
|February 3, 2004
PubMed
Summary

Reconstruction with a sternocleidomastoid muscle flap after total parotidectomy improves cosmetic outcomes. While it may decrease nerve function return, it offers better subjective results for Frey syndrome symptoms.

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Area of Science:

  • Otolaryngology
  • Plastic Surgery
  • Head and Neck Surgery

Background:

  • Total parotidectomy is a surgical procedure to remove the parotid gland.
  • Reconstruction is often necessary to improve functional and cosmetic outcomes.
  • The sternocleidomastoid muscle flap is a common reconstructive technique.

Purpose of the Study:

  • To compare functional and cosmetic outcomes of total parotidectomy with and without sternocleidomastoid muscle flap reconstruction.
  • To evaluate the impact of reconstruction on facial nerve function, greater auricular nerve function, and Frey syndrome.
  • To assess patient satisfaction with cosmetic results.

Main Methods:

  • Retrospective review of 24 patients undergoing total parotidectomy.
  • 15 patients received sternocleidomastoid muscle flap reconstruction; 9 did not.

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  • Outcomes assessed by head and neck surgeons and an aesthetician, including cosmetic appearance, gustatory sweating, and nerve function.

    • Main Results:

    • Reconstruction group showed better cosmetic outcomes (mean follow-up 22 months).
    • No significant difference in facial nerve function, operation length, or hospital stay.
    • Decreased return of greater auricular nerve sensation in the reconstruction group (40% normal vs. 78%).
    • Frey syndrome (gustatory sweating) rates were similar objectively (20% vs. 22%), but fewer clinical symptoms in the reconstruction group.

    Conclusions:

    • Inferiorly based sternocleidomastoid muscle flap improves cosmetic results after total parotidectomy.
    • Potential decrease in greater auricular nerve function return is likely due to nerve stump relocation.
    • No objective benefit in preventing Frey syndrome, but subjective improvement in symptoms was noted.