Submandibular gland flap for reconstruction after parotidectomy

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Parotidectomy can lead to facial volume deficits.
• Reconstruction options aim to restore aesthetics and function.
• The submandibular gland (SMG) flap is a novel approach for this purpose.

Purpose of the Study:

• To describe the surgical technique of an SMG flap pedicled on facial vessels for parotidectomy reconstruction.
• To compare the clinical outcomes of SMG flap reconstruction with sternocleidomastoid muscle (SCM) flaps and no flap reconstruction.

Main Methods:

• Retrospective chart review of 43 parotidectomy cases.
• Patients were divided into three groups: SMG flap (n=13), SCM flap (n=15), and no flap (n=15).
• Analysis of cohort characteristics and complication rates.

Main Results:

• SMG flaps were predominantly used for malignant pathologies (92%) and with neck dissection (100%).
• Immediate postoperative House-Brackmann scores were slightly higher in the SMG flap group (1.6) compared to SCM (1.1) and no flap (1.0).
• Overall complication rates were similar across all reconstruction groups.

Conclusions:

• The SMG flap is a safe and effective option for restoring facial volume post-parotidectomy.
• It offers durable, non-atrophying volume.
• Its anatomical position is advantageous for patients undergoing concurrent level I neck dissection.