Aesthetic parotid surgery: evolution of a technique.

OBJECTIVES/HYPOTHESIS: Described is a technique adopted for surgical management of benign parotid neoplasms with an emphasis on facial reconstruction and prevention of postparotidectomy sequelae.

STUDY DESIGN: Observation/surgical technique.

METHODS: Patients chosen in the last 10 years with benign parotid neoplasms with the application of this technique.

RESULTS: In over 150 cases of benign parotid neoplasms performed in the last 10 years by the senior author using this technique, no cases of clinically significant Frey syndrome were identified. Two cases of marginal nerve paresis transpired, but spontaneously resolved within several months. No cases of postoperative hematoma, wound infection, salivary fistula, or hypertrophic scar formation were noted. Subjectively, patient satisfaction was uniformly high relating to scar appearance and facial contour. There have been no local recurrences to date despite six cases of nonviolated tumor capsule abutting the resection margin.

CONCLUSIONS: The application of a superficial musculoaponeurotic system-platysma flap can alleviate the depression in the retromandibular region following superficial parotidectomy for moderately sized benign neoplasms. It has also shown to help prevent postparotidectomy sequelae of Frey syndrome.