Extracapsular lumpectomy and SMAS flap for benign parotid tumours: An early outcome in a small number of cases on Frey's syndrome and facial nerve dysfunction

Parotidectomy is the most common approach for benign salivary neoplasms. The aim of the present study was to retrospectively analyse no. 34 extracapsular lumpectomies (ELs) performed with superficial musculoaponeurotic system (SMAS) flaps on 32 patients for benign parotid tumours. Based on the extent of the surgical defect the surgical resection was associated with sternocleidomastoid (SCM) muscle rotation flap in 8 patients, superficial temporal artery fascial flap (STAFF) in 2, and temporalis muscle rotation flap in 2. None of the patients affected by pleomorphic adenoma or Warthin's tumour had a complete facial palsy. Only 1 patient (2.9%) had a postoperative transient partial facial paralysis with incomplete eye closure. Neither haematoma formation, nor wound infection was observed, while seroma formation occurred in only 1 patient (2.9%). No cases of Frey's syndrome occurred. An SMAS flap should be performed in primary postparotidectomy reconstruction; a temporoparietal fascia flap (TPFF) if a major defect is anticipated, or when the SMAS has to be resected; an SCM muscle flap covered by an SMAS flap is the method of choice in more extensive rare defects. (C) 2008 European Association for Cranio-Maxillofacial Surgery.