title: [Meta-analysis of surgical techniques for preventing Frey syndrome and a concave facial deformity after parotidectomy].
abstract: OBJECTIVE
  To explore the curative effects on surgical methods for the prevention of Frey syndrome and a concave facial deformity after parotidectomy.
  
  
  METHODS
  A literature search was performed using the Wianfang Database, Chinese Biomedical Literature Disk Database, Chinese Digital Hospital Library and Chinese Scientific Journals Database of VIP from January 1989 to December 2008. Twenty-six Chinese language controlled studies involving surgical techniques for prevention of Frey syndrome and the concave facial deformity after parotidectomy were identified. Review manager 4.2 software was applied for Meta analysis.
  
  
  RESULTS
  Meta-analysis for surgical techniques to prevent symptomatic Frey syndrome, a positive starch-iodine test, and contour deformity, favored intervention with a cumulative odds ratio (OR) of 0.14 [95% confidence interval (CI), 0.07-0.25]; OR, 0.21 (95% CI, 0.17-0.26); and OR, 0.09 (95% CI, 0.04-0.19), respectively. There was a significant difference in the incidence of these complications between surgical treatment groups and control groups (Z = 6.42, Z = 13.70, Z = 6.43, all P < 0.05). The application of a sternocleidomastoid muscle flap decreased the incidence of symptomatic Frey syndrome (Z = 2.33, P < 0.05), positive starch-iodine test (Z = 7.48, P < 0.05) and contour deformity (Z = 7.78, P < 0.05). The application of acellular dermal matrix decreased the incidence of symptomatic Frey syndrome (Z = 6.02, P < 0.05) and positive starch-iodine test (Z = 5.72, P < 0.05) but did not decrease the incidence of contour deformity (Z = 1.27, P > 0.05).
  
  
  CONCLUSIONS
  Meta-analysis of operative techniques to prevent symptomatic Frey syndrome, a positive starch-iodine test, and facial asymmetry suggests that such methods are likely to reduce the incidence of these complications and improve the quality of life after parotidectomy.
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital and Cancer Institute, Chengdu 610041, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Li
authors.forename: Jin-chuan
authors.initials: JC
authors.lastname: Fan
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Jian-chao
authors.initials: JC
authors.lastname: Chen
authors.forename: Zhao-hui
authors.initials: ZH
authors.lastname: Wang
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
authors.forename: Yi-quan
authors.initials: YQ
authors.lastname: Xu
authors.forename: Yu-feng
authors.initials: YF
authors.lastname: Song
authors.forename: Yuan-zhi
authors.initials: YZ
authors.lastname: Xu
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D010306:Parotid Gland / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control / Q000601:surgery*; D013547:Sweating, Gustatory / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D016896:Treatment Outcome