Sternocleidomastoid Flap in Parotid Surgery: A Case Series

Area of Science:

• Otolaryngology
• Plastic Surgery
• Surgical Oncology

Background:

• Parotidectomy for parotid gland neoplasms carries risks including facial nerve palsy, Frey's syndrome, and contour deformities.
• Frey's syndrome (gustatory sweating) significantly impacts patient quality of life.
• Standard parotidectomy techniques have limitations in preventing post-operative complications.

Purpose of the Study:

• To evaluate the efficacy of the sternocleidomastoid flap in preventing Frey's syndrome and contour deformities following parotidectomy.
• To assess the impact of the sternocleidomastoid flap on other complications such as flap necrosis, salivary fistula, and drain-related injuries.
• To compare outcomes between parotidectomy with and without sternocleidomastoid flap reconstruction.

Main Methods:

• A study involving 40 patients undergoing parotidectomy for parotid swellings.
• Patients were divided into two groups: Group A (sternocleidomastoid flap reconstruction) and Group B (no flap reconstruction).
• Outcomes including Frey's syndrome, contour deformities, flap necrosis, and salivary fistula were assessed.

Main Results:

• Frey's syndrome occurred 3 times more frequently in Group B compared to Group A.
• Visible contour deformities were observed in one-third of Group B patients, with none in Group A.
• Group A reported no cases of flap necrosis or salivary fistula, while Group B had 3 and 2 cases, respectively.
• Revision cases indicated better preservation of facial planes with the sternocleidomastoid flap, reducing facial nerve adherence.

Conclusions:

• The sternocleidomastoid flap is an effective method for filling parotidectomy defects.
• Utilizing a sternocleidomastoid flap significantly reduces the incidence of Frey's syndrome and contour deformities.
• This surgical approach improves aesthetic outcomes and minimizes complications like flap necrosis and salivary fistula after parotidectomy.