Patient and Surgeon-Reported Satisfaction With Reconstruction Following Superficial Parotidectomy: A Systematic...

(1) Assess current methods for the collection of patient- and surgeon-reported outcomes after superficial parotidectomy reconstruction. (2) Determine which post-parotidectomy reconstructive method provides the highest degree of patient satisfaction.

PRISMA guidelines were followed for article identification and selection. A total of 17 peer-reviewed articles including 898 patients were included in the study. Outcome data was mathematically harmonized across studies to allow statistical analysis. Random effects meta-analysis of proportions was performed. The Freeman-Tukey Double Arcsine method was used to calculate the pooled estimate, or rate for each analyzed outcome.

No standardized or previously validated instrument was used to collect patient satisfaction data following superficial parotidectomy reconstruction in any of the included studies. After data harmonization, overall patient satisfaction was 93% when no reconstruction was performed, compared to 97% for sternocleidomastoid flap (SCM), and 100% for superficial muscular aponeurotic system flap (SMAS). Patient satisfaction of symmetry was 41% when no reconstruction was performed, compared to 65% for SMAS, 95% for free fat graft, and 96% for SCM.

Reporting methods for patient satisfaction with appearance and symmetry after superficial parotidectomy and reconstruction are heterogeneous and non-standardized. Artificially harmonized data demonstrate that patient-reported outcomes of satisfaction and symmetry were improved following any form of reconstruction after parotidectomy, and patients reported symmetry-specific satisfaction was less when SMAS reconstruction was performed. Validated and objective instruments should be utilized to determine the optimal approach to facial reconstruction after superficial parotidectomy to maximize patient-centered outcomes. Level of Evidence: 3.