title: Free tissue transfer flap reconstruction of parotidectomy defects: outcomes analysis and the utility of three-dimensional laser surface scans.
abstract: BACKGROUND
  Tumours of the parotid gland are generally managed surgically without reconstruction. The usual long-term outcomes of these techniques are facial scars, asymmetry, and permanent contour deficits. These cosmetic deformities can significantly affect patients' self-image and negatively impact their quality of life. Free tissue transfers have been used increasingly over the past years to improve patients' cosmetic and satisfaction outcomes.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the cosmetic and symmetry outcomes of patients undergoing free flap reconstruction after parotid surgery.
  
  
  METHODS
  The study was approved by the ethics review board at the University of Alberta. All patients undergoing total parotid surgery were offered a free flap tissue transfer reconstructive procedure. Seven consecutive patients undergoing the reconstruction option were included in the study. The control group was composed of seven patients who had undergone total parotid surgery without reconstruction. Data regarding demographics, surgical procedure, pathology, and postoperative complications were collected. Facial symmetry was evaluated with questionnaires and laser surface scanning.
  
  
  RESULTS
  There were no statistically significant differences between the two groups with regard to age, sex, timing of surgery, or pathology. The reconstructed patients tended to perceive a better symmetry when compared to the nonreconstructed patients (p = .0014). The reconstructed patients had all experienced a slight volume increase on the operative side compared to the contralateral side, with a mean difference of 4.99% increase in volume. Conversely, the nonreconstructed patients all experienced a notable volume deficit on the operative side compared to the nonoperative side-an average 12.15% volume loss was seen postoperatively. This difference was statistically significant (p ≤ .0001).
  
  
  CONCLUSIONS
  Free tissue transfer reconstruction is an effective means of reconstructing postparotidectomy defects in patients for whom facial volume asymmetry is a concern.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB.
authors.forename: David
authors.initials: D
authors.lastname: Côté
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Harris
authors.forename: Jennifer
authors.initials: J
authors.lastname: Guillemaud
authors.forename: Jason K M
authors.initials: JK
authors.lastname: Chau
authors.forename: Andrew
authors.initials: A
authors.lastname: Grosvenor
authors.forename: Benjamin
authors.initials: B
authors.lastname: King
authors.forename: Hadi
authors.initials: H
authors.lastname: Seikaly
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D010307:Parotid Neoplasms / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome