Prevention of Prey's syndrome and volume deficit after parotidectomy using the superficial temporal artery fascial flap

Frey's syndrome (gustatory sweating)is thought to be caused by aberrant regeneration to the sweat glands of the face. We present a double-layered fascial flap based on the superficial temporal artery which can be used to cover the parotid bed at the time-of parotidectomy and consists of both the temporoparietal fascia and the fascia over the temporalis muscle. We used this superficial temporal artery fascial flap (STAFF) in 24 of 47 patients reviewed after parotid surgery and found a significantly lower incidence of gustatory sweating and a far less noticeable post-parotidectomy volume deficit or 'hollow'.