Assessment of functional outcome after parotidectomy reconstruction

Authors

  • Jitendra Kumar Department of Otorhinolaryngology and Head Neck Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Sunil Kumar Department of Otorhinolaryngology and Head Neck Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • H. P. Singh Department of Otorhinolaryngology and Head Neck Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Veerendra Verma Department of Otorhinolaryngology and Head Neck Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
  • Anupam Mishra Department of Otorhinolaryngology and Head Neck Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20181871

Keywords:

Parotidectomy, Sternocleidomastoid flap, Functional outcome

Abstract

Background: Total or superficial parotidectomy, when a reconstructive technique is not used, usually leads to Frey’s syndrome, preauricular and retromandibular depression. These together with the scar from a classic or modified Blair incision limit the final aesthetic outcome. The superiorly based sternocleidomastoid muscle (SCM) flap or superficial musculo-aponeurotic system (SMAS) flap can be used for reconstruction of the defect to achieve better facial contour restoration. The aim and objective of the study was to evaluate the functional and cosmetic outcome of patients after reconstruction in parotid surgeries.

Methods: This study was done in the department of Otorhinolaryngology & Head-Neck Surgery. Total number of patients with parotid tumours were 24 in each group namely- Group A: Patients undergoing parotid surgery without reconstruction. Group B: Patients undergoing parotid surgery with reconstruction using superiorly based sternocleidomastoid muscle flap. All patients were followed and analyzed on 6 weeks, 6 months and 1 year postoperatively on the basis of patient’s satisfaction, cosmesis, subjective Frey’s syndrome, retromandibular and pre-auricular depression using visual analogue scale.  

Results: In Group A, subjective Frey’s syndrome was present in 8.3% patients from 6 month to 1 year. In contrast, in Group B, it remain absent in all patients at all periods. In Group A, preauricular depression was present in 79.2% patients in immediate postop and 95.8% patients from 6 week to 1 year. In contrast, in Group B, it was present in only 4.2% patients at all periods. In Group A, retromandibular depression was present in 70.8% patients while in Group B, it was absent in all patients.

Conclusions: The superiorly based SCM flap for reconstruction of defect following superficial or total parotidectomy improves the final outcome in terms of the facial deformity (pre-auricular, retro-auricular depression) and lowers the incidence of Frey’s syndrome.

References

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Published

2018-04-26

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Original Research Articles