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Free fat grafting in superficial parotid surgery to prevent Frey's syndrome and improve aesthetic outcome

Published online by Cambridge University Press:  09 July 2013

L S Chan ,
M S Barakate  and
T E Havas
L S Chan*
Affiliation:
Department of Otolaryngology, The Prince of Wales Hospital, Randwick, New South Wales, Australia
M S Barakate
Affiliation:
Department of Otolaryngology, The Prince of Wales Hospital, Randwick, New South Wales, Australia
T E Havas
Affiliation:
Department of Otolaryngology, The Prince of Wales Hospital, Randwick, New South Wales, Australia
*
Address for correspondence: Dr Lyndon Chan, 20 Ducane St, Forrest, ACT, Australia2603 Fax: +61 2 4922 3344 E-mail: lyndonsch@gmail.com
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Abstract

Background:

Frey's syndrome and cosmesis are important considerations in parotid surgery. Placement of an interpositional barrier can prevent these complications; however, surgical technique and efficacy remain controversial.

Methods:

A prospective case series was collected comprising all patients undergoing primary superficial parotidectomy for benign pathology with abdominal free fat grafting between June 2007 and December 2010, performed by a single surgeon. A survey was also distributed to otorhinolaryngology consultants across Australia to assess current practice.

Results:

Twenty-eight patients were included. No patient had clinical symptoms of Frey's syndrome. Seventy-five per cent of patients were completely satisfied with their aesthetic outcome, 18 per cent scored 4/5 and the remaining 7 per cent (2 patients) scored 3/5. The survey revealed that 79 per cent of respondents did not use interpositional grafts.

Conclusion:

Abdominal free fat is ideal for grafting as it is an effective, safe, simple, accessible, fast and inexpensive method of providing an interpositional graft.

Keywords

Parotid GlandSweatingGustatoryAestheticsGraftingFatAbdominal
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Supplement S1 , January 2014 , pp. S44 - S49
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented as a poster at the Australian Society of Otolaryngology Head and Neck Surgery 2012 Annual Scientific Meeting, 1 April 2012, Adelaide, South Australia, Australia

References

1Albergotti, W, Nguyen, S, Zenk, J, Gillespie, MB. Extracapsular dissection for benign parotid tumours: a meta-analysis. Laryngoscope 2012;122:1954–60CrossRefGoogle ScholarPubMed
2Curry, J, King, N, Reiter, D, Fisher, K, Heffelfinger, R, Pribitkin, E. Meta-analysis of surgical techniques for preventing parotidectomy sequelae. Arch Facial Plast Surg 2009;11:327–31CrossRefGoogle ScholarPubMed
3Sanabria, A, Kowalski, L, Bradley, P, Hartl, D, Bradford, C, de Bree, R et al. Sternocleidomastoid muscle flap in preventing Frey's syndrome after parotidectomy: a systematic review. Head Neck 2012;34:589–98CrossRefGoogle ScholarPubMed
4Bianchi, B, Ferri, A, Ferrari, S, Copelli, C, Sesenna, E. Improving esthetic results in benign parotid surgery: statistical evaluation of facelift approach, sternocleidomastoid flap, and superficial musculoaponeurotic system flap application. J Oral Maxillofac Surg 2011;69:1235–41CrossRefGoogle ScholarPubMed
5Asal, K, Köybaşioğlu, A, Inal, E, Ural, A, Uslu, S, Ceylan, A et al. Sternocleidomastoid muscle flap reconstruction during parotidectomy to prevent Frey's syndrome and facial contour deformity. Ear Nose Throat J 2005;84:173–6CrossRefGoogle ScholarPubMed
6Bonanno, P, Palaia, D, Rosenberg, M, Casson, P. Prophylaxis against Frey's syndrome in parotid surgery. Ann Plast Surg 2000;44:498–501CrossRefGoogle ScholarPubMed
7Taylor, S, Yoo, J. Prospective cohort study comparing subcutaneous and sub-superficial musculoaponeurotic system flaps in superficial parotidectomy. J Otolaryngol 2003;32:71–6CrossRefGoogle ScholarPubMed
8Ahmed, O, Kolhe, P. Prevention of Frey's syndrome and volume deficit after parotidectomy using the superficial temporal artery fascial flap. Br J Plast Surg 1999;52:256–60CrossRefGoogle ScholarPubMed
9Cesteleyn, L, Helman, J, King, S, Van de Vyvere, G. Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey's syndrome. J Oral Maxillofac Surg 2002;60:1284–97CrossRefGoogle ScholarPubMed
10Elliott, R, Weinstein, G, Low, D, Wu, L. Reconstruction of complex total parotidectomy defects using the free anterolateral thigh flap: a classification system and algorithm. Ann Plast Surg 2011;66:429–37CrossRefGoogle ScholarPubMed
11Valentini, V, Cassoni, A, Marianetti, TM, Battisti, A, Terenzi, V, Iannetti, G. Anterolateral thigh flap for the reconstruction of head and neck defects: alternative or replacement of the radial forearm flap? J Craniofac Surg 2008;19:1148–53CrossRefGoogle ScholarPubMed
12Dulguerov, P, Quinodoz, D, Cosendai, G, Piletta, P, Marchal, F, Lehmann, W. Prevention of Frey syndrome during parotidectomy. Arch Otolaryngol Head Neck Surg 1999;125:833–9CrossRefGoogle ScholarPubMed
13Sachsman, S, Rice, D. Use of AlloDerm implant to improve cosmesis after parotidectomy. Ear Nose Throat J 2007;86:512–13CrossRefGoogle ScholarPubMed
14Sinha, U, Saadat, D, Doherty, C, Rice, D. Use of AlloDerm implant to prevent Frey syndrome after parotidectomy. Arch Facial Plast Surg 2003;5:109–12CrossRefGoogle ScholarPubMed
15Nosan, D, Ochi, J, Davidson, T. Preservation of facial contour during parotidectomy. Otolaryngol Head Neck Surg 1991;104:293–8CrossRefGoogle ScholarPubMed
16Harada, T, Inoue, T, Harashina, T, Hatoko, M, Ueda, K. Dermis-fat graft after parotidectomy to prevent Frey's syndrome and the concave deformity. Ann Plast Surg 1993;31:450–2CrossRefGoogle ScholarPubMed
17Curry, J, Fisher, K, Heffelfinger, R, Rosen, M, Keane, W, Pribitkin, E. Superficial musculoaponeurotic system elevation and fat graft reconstruction after superficial parotidectomy. Laryngoscope 2008;118:210–15CrossRefGoogle ScholarPubMed
18Conger, B, Gourin, C. Free abdominal fat transfer for reconstruction of the total parotidectomy defect. Laryngoscope 2008;118:1186–90CrossRefGoogle ScholarPubMed
19de Bree, R, van der Waal, I, Leemans, C. Management of Frey syndrome. Head Neck 2007;29:773–8CrossRefGoogle ScholarPubMed
20Luna-Ortiz, K, Sansón-RíoFrío, J, Mosqueda-Taylor, A. Frey syndrome. A proposal for evaluating severity. Oral Oncol 2004;40:501–5CrossRefGoogle ScholarPubMed
21Mohammed, F, Asaria, J, Payne, R, Freeman, J. Retrospective review of 242 consecutive patients treated surgically for parotid gland tumours. J Otolaryngol Head Neck Surg 2008;37:340–6Google ScholarPubMed
22Linder, T, Huber, A, Schmid, S. Frey's syndrome after parotidectomy: a retrospective and prospective analysis. Laryngoscope 1997;107:1496–501CrossRefGoogle ScholarPubMed
23Owen, E, Banerjee, A, Kissin, M, Kark, A. Complications of parotid surgery: the need for selectivity. Br J Surg 1989;76:1034–5CrossRefGoogle ScholarPubMed
24Clayman, M, Clayman, S, Seagle, M. A review of the surgical and medical treatment of Frey syndrome. Ann Plast Surg 2006;57:581–4CrossRefGoogle ScholarPubMed
25Bray, D, Hopkins, C, Roberts, D. A review of dermal fillers in facial plastic surgery. Curr Opin Otolaryngol Head Neck Surg 2010;18:295–302CrossRefGoogle ScholarPubMed
26Neuber, G. Fat transplantation [in German]. Chir Kongr Verhandl Dtsch Gesellsch Chir 1893;22:66Google Scholar
27Boyce, R, Nuss, D, Kluka, E. The use of autogenous fat, fascia, and nonvascularized muscle grafts in the head and neck. Otolaryngol Clin North Am 1994;27:39–68CrossRefGoogle ScholarPubMed
28Ersek, R. Transplantation of purified autologous fat: a 3-year follow-up is disappointing. Plast Reconstr Surg 1991;87:219–27CrossRefGoogle ScholarPubMed
29Matsudo, P, Toledo, L. Experience of injected fat grafting. Aesthetic Plast Surg 1988;12:35–8CrossRefGoogle ScholarPubMed
30Pinski, K, Roenigk, HJ. Autologous fat transplantation. Long-term follow-up. J Dermatol Surg Oncol 1992;18:179–84CrossRefGoogle ScholarPubMed
31Fontdevila, J, Serra-Renom, J, Raigosa, M, Berenguer, J, Guisantes, E, Prades, E et al. Assessing the long-term viability of facial fat grafts: an objective measure using computed tomography. Aesthet Surg J 2008;28:380–6CrossRefGoogle ScholarPubMed
32Witt, R. The significance of the margin in parotid surgery for pleomorphic adenoma. Laryngoscope 2002;112:2141–54CrossRefGoogle ScholarPubMed
33Casler, J, Conley, J. Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey's syndrome. Laryngoscope 1991;101:95–100CrossRefGoogle ScholarPubMed
34Bonanno, P, Casson, P. Frey's syndrome: a preventable phenomenon. Plast Reconstr Surg 1992;89:452–6CrossRefGoogle ScholarPubMed
35Allison, G, Rappaport, I. Prevention of Frey's syndrome with superficial musculoaponeurotic system interposition. Am J Surg 1993;166:407–10CrossRefGoogle ScholarPubMed
36Taylor, S, Yoo, J, Matthews, T, Lampe, H, Trites, J. Frey's syndrome and parotidectomy flaps: a retrospective cohort study. Otolaryngol Head Neck Surg 2000;122:201–3CrossRefGoogle ScholarPubMed
37Wille-Bischofberger, A, Rajan, G, Linder, T, Schmid, S. Impact of the SMAS on Frey's syndrome after parotid surgery: a prospective, long-term study. Plast Reconstr Surg 2007;120:1519–23CrossRefGoogle ScholarPubMed
38Teknos, T, Nussenbaum, B, Bradford, C, Prince, M, El-Kashlan, H, Chepeha, D. Reconstruction of complex parotidectomy defects using the lateral arm free tissue transfer. Otolaryngol Head Neck Surg 2003;129:183–91CrossRefGoogle ScholarPubMed
39Rappaport, I, Allison, G. Superficial musculoaponeurotic system amelioration of parotidectomy defects. Ann Plast Surg 1985;14:315–23CrossRefGoogle ScholarPubMed
40Arden, R, Miguel, G. Aesthetic parotid surgery: evolution of a technique. Laryngoscope 2011;121:2581–5CrossRefGoogle ScholarPubMed
41Kornblut, A, Westphal, P, Miehlke, A. A reevaluation of the Frey syndrome following parotid surgery. Arch Otolaryngol 1977;103:258–61CrossRefGoogle ScholarPubMed
42Athavale, S, Phillips, S, Mangus, B, Datta, J, Sinard, R, Netterville, J et al. Complications of alloderm and dermamatrix for parotidectomy reconstruction. Head Neck 2012;34:88–93CrossRefGoogle ScholarPubMed