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Updated: Jul 10, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Reconstruction after total parotidectomy using a de-epithelialized free flap
Federico Biglioli1, Luca Autelitano
1Department of Maxillo-Facial Surgery, San Paolo University Hospital, Milan, Italy. federico.biglioli@unimi.it
Summary
A de-epithelialized parascapular free flap effectively reconstructs tissue defects after total parotidectomy, preventing Frey's syndrome and ensuring good aesthetic outcomes.
Area of Science:
- Reconstructive surgery
- Head and neck surgery
- Plastic surgery
Background:
- Total parotidectomy can lead to aesthetic and functional deficits, including Frey's syndrome and soft tissue depression.
- Reconstruction aims to mitigate these sequelae by restoring volume and preventing Frey's syndrome using stable tissues.
Observation:
- A novel method utilizing a de-epithelialized parascapular free flap was employed for immediate repair following total parotidectomy.
- Two patients with recurrent sialoadenolithiasis and adenocarcinoma underwent this procedure, with secondary flap thinning performed in both cases.
Findings:
- Both patients achieved satisfactory aesthetic results.
- Neither patient developed Frey's syndrome post-operatively.
Implications:
- The de-epithelialized parascapular free flap offers a reliable method for addressing post-parotidectomy defects.
- This technique provides sufficient vascularized tissue for stable, aesthetically pleasing reconstruction, avoiding functional complications like Frey's syndrome.