Evaluation of superficial musculoaponeurotic system flap and fat graft outcomes for benign and malignant parotid disease.

Abstract

OBJECTIVE:

(1) To evaluate the effectiveness of the superficial musculoaponeurotic system (SMAS) flap and free fat graft in reconstructing the parotidectomy defect. (2) To evaluate the long-term viability of the free fat graft following parotidectomy for benign and malignant disease, including in the postradiation setting.

STUDY DESIGN:

Prospective study of consecutive patients.

SETTING:

Academic tertiary care medical center. Subjects and Methods Thirty-one consecutive patients underwent parotidectomy with SMAS flap and free fat graft reconstruction from 2006 to 2012. Data were compiled through a manual chart review.

RESULTS:

Twenty-three of the 31 total patients had benign disease, including pleomorphic adenoma, oncocytoma, and Warthin tumor. The 8 remaining patients (9 parotidectomies) underwent surgery for malignant disease, followed by postoperative radiation. The average age was 56 years (range, 16-84 years). The mean follow-up was 22.5 months. Satisfactory volumetric symmetry was achieved in all procedures for benign and malignant disease. Magnetic resonance imaging confirmed long-term fat graft viability in the postradiation setting. There was 1 case of Frey syndrome and no cases of unexpected, permanent facial nerve weakness among the patients.

CONCLUSION:

The combined technique of SMAS flap and free fat graft is effective for immediate reconstruction of the parotidectomy defect with minimal morbidity and low complication rates. This study demonstrates long-term viability of the free fat graft even in the setting of postoperative radiation.

• Authors: Bryan T Ambro, Lindsay A Goodstein, Robert E Morales, Rodney J Taylor
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 148 Issue 6 Pg. 949-54 (Jun 2013) ISSN: 1097-6817 [Electronic] England
• PMID: 23358951 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Topics

• Academic Medical Centers
• Adipose Tissue (surgery, transplantation)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biopsy, Needle
• Cohort Studies
• Esthetics
• Female
• Graft Rejection
• Graft Survival
• Humans
• Immunohistochemistry
• Male
• Middle Aged
• Parotid Diseases (pathology, surgery)
• Parotid Neoplasms (pathology, surgery)
• Plastic Surgery Procedures (adverse effects, methods)
• Retrospective Studies
• Risk Assessment
• Subcutaneous Tissue (surgery, transplantation)
• Surgical Flaps (blood supply)
• Treatment Outcome
• Wound Healing (physiology)
• Young Adult