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Reconstructive techniques of the parotid region
Giovanni Dell'aversana Orabona1, Giovanni Salzano, Marzia Petrocelli
1From the *Deparment of Maxillofacial Surgery; †Department of Neurosurgery; and ‡Eye Department, University of Naples Federico II, Naples, Italy.
The Journal of Craniofacial Surgery
|April 8, 2014
Summary
Extracapsular dissection for benign parotid tumors is as effective as superficial parotidectomy but with fewer complications. Reconstruction techniques significantly reduce Frey syndrome and other post-operative issues.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Plastic and Reconstructive Surgery
Background:
- Benign parotid tumors require surgical removal, often necessitating reconstruction to prevent aesthetic and functional deficits.
- Reconstruction techniques include superficial musculoaponeurotic system (SMAS) flap, sternocleidomastoid muscle flap, and temporoparietal fascia flap.
Purpose of the Study:
- To compare the complications associated with three reconstructive techniques following benign parotid tumor removal.
- To evaluate the effectiveness of extracapsular dissection versus superficial parotidectomy in managing benign parotid disease.
Main Methods:
- A retrospective review of 224 patients with benign parotid tumors treated between 2002 and 2009.
- Surgical procedures included extracapsular dissection or superficial parotidectomy with reconstruction using SMAS flap, sternocleidomastoid muscle flap, or temporoparietal fascia flap.
- Statistical analysis using the chi-squared test to compare recurrence rates and complications between surgical techniques and flap types.
Main Results:
- Extracapsular dissection and superficial parotidectomy showed no significant difference in hematoma or wound infection rates.
- Superficial parotidectomy resulted in significantly higher rates of transient facial nerve weakness, fistula, skin depression, Frey syndrome, spinal nerve injury, and facial paralysis compared to extracapsular dissection.
- All three reconstruction techniques significantly reduced the incidence of Frey syndrome and other functional and aesthetic complications.
Conclusions:
- Extracapsular dissection is a viable alternative to superficial parotidectomy for benign parotid tumors, offering comparable effectiveness with fewer complications.
- The employed reconstructive techniques are crucial in mitigating post-parotidectomy sequelae, improving both functional and aesthetic outcomes.
