Surgical Procedures for Prevention of Frey’s Syndrome after Parotidectomy Surgery: Review Article

Background: Treatment options for benign and malignant parotid gland neoplasms include superficial and whole parotidectomy, however patients often suffer from facial contour deformation in the preauricular and retromandibular regions, as well as Frey's syndrome. Preauricular flushing and sweating following parotid surgery has been noted as a possible side effect. Once thought to be extremely rare, it has been found to occur anywhere from 4% to 62% in post-parotidectomy patients within the first six to 18 months following surgery. These outcomes have been attempted to be avoided by the use of certain intraoperative procedures. Dermal-fat-free grafts, fascia lata grafts as well as superficial flaps of the musculoaponeurotic system, vascularized fat grafts, temporoparietal fascia flaps, as well as implants of polytetrafluoroethylene are a few of the other options available.
Objective: To evaluate  aesthetic and functional outcomes after the use of  either superiorly based sternocleidomastoid muscle flap or free abdominal fat after parotidectomy.
Methods: The databases were searched for articles published in English in 4 data bases; PubMed, Google scholar, Egyptian Knowledge Bank and Science direct. Boolean operators (AND, OR, NOT) had been used such as [Frey’s Syndrome  AND Parotidectomy Surgery OR Prevention of Frey’s Syndrome]  and in peer-reviewed articles between January 2001 and October 2020.
Conclusion: Superiorly based Sternocleidomastoid muscle flap improves facial deformity following either superficial or total parotidectomy by lowering the occurence of Frey's syndrome objectively as well as subjectively compared to risks of postoperative complications at the donor site associated with free abdominal fat reconstruction, which has a high incidence  of partially fat absorption or liquefaction.