Parotidectomy for benign parotid tumors: an aesthetic approach

The sternocleidomastoid (SCM) partial thickness muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. The technique was combined with a face lift incision to further improve the outcome.

At the National Cancer Institute, Cairo University, Egypt, 23 patients presenting with benign tumors underwent parotidectomy, 19 had superficial parotidectomy and four had total parotidectomy done. The superiorly based (SCM) muscle flap was used to correct the contour deformity. The aesthetic result was evaluated by assessing and scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle to their contralateral normal sides. The overall aesthetic appearance was then calculated by the summation of the scores of the latter three parameters. Patients' satisfaction was assessed by patients' questionnaire.

The overall aesthetic appearance was good in 17 patients, and moderate in six patients. 16/23 patients had an overall deep satisfaction with the result. The residual hollowness of the parotid following reconstruction of the total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome.

Superficial parotidectomy through facelift incision with immediate reconstruction with superiorly based partial thickness SCM flap allows adequate resection of most benign parotid tumors with a satisfactory aesthetic outcome and minimal donor site morbidity.