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. 2025 Apr 22;29(2):1-7.
doi: 10.1055/s-0044-1788911. eCollection 2025 Apr.

Esthetic and Functional Outcomes of Superficial Parotidectomy Comparing Three Reconstruction Techniques: An Interventional Clinical Study

Sherif Mohammad Askar  1 , Abd ElRaof Said Mohamed  1 , Tamer Oraby  1 , Ibrahim Khaled  1 , Mahmoud Megahed  1 , Ali Awad  1
Affiliations

Esthetic and Functional Outcomes of Superficial Parotidectomy Comparing Three Reconstruction Techniques: An Interventional Clinical Study

Sherif Mohammad Askar et al. Int Arch Otorhinolaryngol. .

Abstract

Introduction Preauricular defect is one of the main concerns after superficial parotidectomy. Plastic surgeons have described many filling techniques to overcome the problem. Objective To discuss three reconstruction techniques after superficial parotidectomy: partial-thickness, superiorly based sternocleidomastoid muscle flap; en-bloc fat graft; and platelet-rich fibrin gel, with a comparison of aesthetic and functional outcomes. Methods The present study included 29 adult patients submitted to reconstruction after superficial parotidectomy by partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat graft, and platelet-rich fibrin gel. A subjective evaluation of the facial nerve functions was conducted through a visual analog scale (VAS) with scores from 0 to 5, which was completed by the patient, a close relative, and 3 blinded staff members. Results Regarding the VAS, in the comparison of the 3 groups at the sixth and twelfth postoperative months, the fat-graft group reported the highest mean values for satisfaction (3.4 ± 1.1 and 3.83 ± 0.97 respectively). The fat-graft group also showed highly significant differences when compared with the groups submitted to the sternocleidomastoid muscle flap ( p = 0.0001) and the platelet-rich fibrin gel techniques ( p = 0.016). Conclusion Parotidectomy with immediate reconstruction of the surgical defect through an en-block fat graft provides better esthetic outcomes than sternocleidomastoid muscle flap and platelet-rich fibrin gel after one year. The patients submitted to the sternocleidomastoid muscle flap and fat-graft techniques reported minimal surgical site morbidity and a lower chance of developing Frey syndrome. The fat graft resulted in the best degree of cosmetic satisfaction, with minimal morbidity. Fat overcorrection is recommended.

Keywords: fat graft; sternomastoid muscle flap; superficial parotidectomy.

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Conflict of interest statement

Conflict of Interests The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
Partial-thickness, superiorly based sternocleidomastoid muscle flap.
Fig. 2
Fig. 2
The fat-graft in place.
Fig. 3
Fig. 3
The platelet-rich fibrin gel in place.
Fig. 4
Fig. 4
Mean scores on the Visual Analog Scale (VAS-f) at 6 and 12 months postoperatively for the three groups according to different evaluators.
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