The efficacy of modified sternocleidomastoid muscle flap in preventing sialocele and salivary fistula following partial superficial parotidectomy.

BACKGROUND

Sialocele and salivary fistula are well-established early postoperative complications following partial superficial parotidectomy (PSP).

AIMS: This study aims to evaluate the effectiveness of the modified sternocleidomastoid muscle (MSCM) flap performed prophylactically following PSP to prevent sialocele and salivary fistula formation.

METHODS

This retrospective cohort study included 230 patients who underwent PSP for benign parotid neoplasia at a tertiary referral center between 2012 and 2024. The primary independent variable was the surgical management (MSCM flap vs. no flap following PSP), while the primary outcome variable was the development of a sialocele or a subsequent salivary fistula. The chi-squared (χ2) test was utilized for group comparisons, while Fisher's exact test was employed when cell counts were less than 5.

RESULTS

The study cohort comprised 230 patients with a mean age of 51 ± 19, and 51.3% were male. Sialoceles occured in 2 (10%) patients in the MSCM flap group compared to 76 (36.2%) in the control group (p = 0.024). Notably, no salivary fistulas (0%) developed in the MSCM flap group, whereas 23 (10.9%) cases occurred in the control group (p = 0.05).

CONCLUSION

The MSCM flap technique is an effective and reliable surgical method for preventing the development of both sialocele and salivary fistula following PSP.