title: Sternocleidomastoid muscle flap in preventing Frey's syndrome after parotidectomy: a systematic review.
abstract: BACKGROUND
  Parotidectomy is a common procedure and Frey's syndrome (gustatory sweating) is a common side effect. The current literature was assessed concerning the effectiveness of the sternocleidomastoid muscle (SCM) flap to prevent Frey's syndrome after parotidectomy.
  
  
  METHODS
  A bibliography search was conducted for studies published between 1966 and 2010 and included randomized controlled trials (RCTs) or cohort studies with patients undergoing parotidectomy with facial nerve preservation. The outcome measures of particular interest were the incidence of Frey's syndrome and cosmetic impairment.
  
  
  RESULTS
  In all, 12 studies were selected (1 meta-analysis of all interventions to prevent Frey's syndrome, 2 RCTs, and 9 cohort studies). The trials were too heterogeneous to perform a meta-analysis on the effect of the SCM flap. The results reported by the authors of each study suggest an objective decrease in Frey's syndrome when the SCM flap was used, but there was no difference in the patients' subjective reporting of symptoms. However, this conclusion is prone to the biases inherent in these studies, and thus overall it is impossible to make any recommendation.
  
  
  CONCLUSIONS
  Current reported evidence is inconclusive as to the use of SCM muscle flap as an intervention to prevent Frey's syndrome following parotid surgery.
authors.affiliation: Department of Surgery, Universidad de La Sabana-Fundacion Abood Shaio, Bogota, Colombia.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Sanabria
authors.forename: Luiz P
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bradley
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D018849:Controlled Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery / Q000637:transplantation*; D010306:Parotid Gland / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000379:methods; D013547:Sweating, Gustatory / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome