Modified superficial parotidectomy: preserving both the great auricular nerve and the parotid gland fascia.
OBJECTIVE
To reduce the incidence of sensory deficits and Frey's syndrome by modifying the traditional superficial parotidectomy.


METHODS
After raising the skin flap, the parotid gland fascia (PGF) was elevated to form a posterior pedicle fascial flap and then was replaced after the gland removal. The great auricular nerve (GAN) that runs within the PGF was not separated, so both the GAN and the PGF were preserved. Before this modification, the GAN and PGF were examined anatomically. The complication rates in the modified and control groups were compared.


RESULTS
1) The GAN, which runs within the thick and pycnotic PGF, trifurcates into postauricular, preauricular and lobule branches. The modification could be carried out practically based on the anatomy study. 2) Long-term sensory deficit was encountered in 13.3% of the control group, but 0% in the modified one. Frey's syndrome was suffered by 66.7% and 16.7% cases in the control and modified group respectively. The incidence of other complications was not significantly different.


CONCLUSIONS
Our modification is practical. It decreases the complications significantly.


METHODS
B-3b.
Zumeng
Ya
Y
Department of Maxillofacial & Plastic Surgery, The Second Affiliated Hospital, Chongqing University of Medical Science, Chongqing 400010, People's Republic of China. yazumeng@163.com
Zhi
Gao
G
Gang
Zhang
Z
Jianhua
Wang
W
Yinghui
Tan
T
D008949:Adenoma, Pleomorphic / Q000601:surgery; D000328:Adult; D000368:Aged; D002102:Cadaver; D002572:Cervical Plexus / Q000033:anatomy & histology; D005154:Facial Nerve / Q000033:anatomy & histology; D005205:Fascia / Q000098:blood supply / Q000294:innervation; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000294:innervation / Q000601:surgery; D010306:Parotid Gland / Q000294:innervation / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D013524:Surgical Flaps / Q000473:pathology; D013547:Sweating, Gustatory / Q000209:etiology / Q000517:prevention & control