Free tissue transfer flap reconstruction of parotidectomy defects: outcomes analysis and the utility of three-dimensional laser surface scans
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Published on: December 5, 2025
David Côté1, Jeffrey R Harris, Jennifer Guillemaud
1Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB.
Background:
Tumours of the parotid gland are generally managed surgically without reconstruction. The usual long-term outcomes of these techniques are facial scars, asymmetry, and permanent contour deficits. These cosmetic deformities can significantly affect patients' self-image and negatively impact their quality of life. Free tissue transfers have been used increasingly over the past years to improve patients' cosmetic and satisfaction outcomes.
Objective:
The purpose of this study was to evaluate the cosmetic and symmetry outcomes of patients undergoing free flap reconstruction after parotid surgery.
Methods:
The study was approved by the ethics review board at the University of Alberta. All patients undergoing total parotid surgery were offered a free flap tissue transfer reconstructive procedure. Seven consecutive patients undergoing the reconstruction option were included in the study. The control group was composed of seven patients who had undergone total parotid surgery without reconstruction. Data regarding demographics, surgical procedure, pathology, and postoperative complications were collected. Facial symmetry was evaluated with questionnaires and laser surface scanning.
Results:
There were no statistically significant differences between the two groups with regard to age, sex, timing of surgery, or pathology. The reconstructed patients tended to perceive a better symmetry when compared to the nonreconstructed patients (p = .0014). The reconstructed patients had all experienced a slight volume increase on the operative side compared to the contralateral side, with a mean difference of 4.99% increase in volume. Conversely, the nonreconstructed patients all experienced a notable volume deficit on the operative side compared to the nonoperative side-an average 12.15% volume loss was seen postoperatively. This difference was statistically significant (p ≤ .0001).
Conclusions:
Free tissue transfer reconstruction is an effective means of reconstructing postparotidectomy defects in patients for whom facial volume asymmetry is a concern.