Temporoparietal fascia flaps and superficial musculoaponeurotic system plication in parotid surgery reduces Frey's syndrome

Purpose: The purpose of this retrospective study was to evaluate the incidence of Frey's syndrome after parotid gland surgery with elevation of a skin flap versus the interposition of musculoaponeurotic tissue between the skin and the facial nerve. Materials and Methods: The standard skin flap was used in 122 patients (1981 to 1989), whereas interposition of temporoparietal galea or superficial musculoaponeurotic system was performed in 146 consecutive patients (1989 to 1998). Results: The incidence of Frey's syndrome was reduced from 33% to 4% with the use of a musculoaponeurotic layer, and the mean duration of postoperative facial nerve paresis decreased from 3 months to 6 weeks. Conclusions: Consideration should be given to the use of an interpositional layer of tissue between the facial nerve and the skin flap to reduce the incidence of Frey's syndrome after parotid gland surgery. (C) 2002 American Association of Oral and Maxillofacial Surgeons.