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Use of Parotid Gland Fascia in the Prevention of Frey Syndrome after Parotidectomy

Ogino, Akihiro, MD; Onishi, Kiyoshi, MD; Nakamichi, Miho, MD; Okaneya, Tetsuya, MD

doi: 10.1097/SCS.0000000000005458
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Background: Superficial parotidectomy is standard surgical procedure for parotid gland tumor, and Frey syndrome and depressed deformity of the region are often seen as complications. In this study, we performed prevention of Frey syndrome by covering the residual parotid gland defect with the parotid gland fascia flap.

Method: The subjects were 5 patients with parotid gland tumor. Tumor was localized in the inferior and superior poles of the parotid gland in 3 and 2 patients, respectively, and it was confirmed on preoperative diagnostic imaging that the tumor and parotid gland fascia were not present in close proximity. Through Lazy-S incision, main trunk of facial nerve was identified and conserved following the surgical procedure of normal superficial parotidectomy, and the superficial parotid gland containing tumor was elevated. A parotid gland fascia flap with a pedicle on the nasal side was prepared and the defect after superficial parotidectomy was covered with it.

Results: The facial nerve and resected parotid gland stump could be sufficiently covered with the parotid gland fascia flap in all patients. The mean duration of postoperative follow-up was 36 months (10 months-4 years and 5 months), and there were no complications such as tumor recurrence, Frey syndrome, salivary gland fistula, or severe concavity in the parotid region.

Conclusion: Although application of the present procedure is limited to patients in whom the parotid gland fascia and tumor are not located in close proximity, it may be useful to prevent Frey syndrome because extension of incision is not necessary, the surrounding tissue is not sacrificed, the flap can be easily elevated, and the parotid gland stump can be sufficiently covered.

Department of Plastic and Reconstructive Surgery, Toho University Omori Medical Center, Tokyo, Japan.

Address correspondence and reprint requests to Akihiro Ogino, MD, Department of Plastic and Reconstructive Surgery, Toho University Omori Medical Center, 6-11-1, Omori-nishi, Ota-ku, Tokyo 143-8541, Japan; E-mail: akihiro.ogino@med.toho-u.ac.jp

Received 31 August, 2018

Accepted 11 February, 2019

This article is presented at the 23rd Annual Meeting of the Japanese Society for Innovative Techniques in Plastic Surgery (February 10 2018, Hyogo, Japan).

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.