Modified Face-lift Incision Combined With A Superficially Anterior And Superior-based Sternocleidomastoid Muscle Flap In Total Parotidectomy

Objective The aim of this paper was to evaluate a modified total parotidectomy performed through a modified face-lift incision combined with a superficially anterior and superior pedicled sternocleidomastoid muscle (SASSCM) flap.Methods Between2007and2011,81patients with parotid disease were operated.66patients were retrospectively assigned to two groups according to the surgical technique:I (34)modified face-lift incision combined with a superfiacially anterior and superior pedicled sternocleidomastoid muscle flap, II (32)"S" shape incision without any reconstruction. All patients were followed up for one year at least. Cosmetic gratification, presence or absence of gustatory flushing or sweating, facial paralysis and functional reversion of great auricular nerve (GAN) were evaluated through subjective and objective index.Results Records of66cases of total parotidectomy were reviewed retrospectively.25(38%) patients’pathological reports were pleomorphic adenoma,7(11%) were Warthin tumor,5were basal cell adenoma,4were lipoma,1was vascular malformation,4were myoepithelial adenoma,4were mucoepidermoid carcinoma,4were acinic cell carcinoma,5were adenoid cystic carcinoma,1was tuberculosis,6(9%) were lympha epithelial lesion.16(24%) patients developed symptoms of Frey’s syndrome.7patients developed transient facial paralysis after surgery and disappeared6months after surgery.23patients developed numbness in front of the skin of ear and behind the ear. Other complications was depression in retromandibular and upper cervical area.The average of depression in retromandibular of patients in experimental group was4.35mm and was significantly improved,which compared with the control group. Patients in experimental group were most satisfied with modified face-lift approach combined with a superficially anterior and superior-based sternocleidomastoid muscle flap.Conclusion The facelift incision combined with a superficially anterior and superior pedicled sternocleidomastoid muscle (SASSCM) flap is a simple and efficient way for preventing Frey’s syndrome and lead to a highstatistically significant improvement in the esthetic outcome.