title: Modified facelift approach combined with a superficial musculoaponeurotic system flap in the treatment of benign parotid tumors.
abstract: OBJECTIVE
  The purpose of this study was to investigate the adequacy of a modified facelift incision combined with an SMAS flap for the resection of benign parotid lesions in terms of cosmesis and incidence of Frey's syndrome.
  
  
  METHODS
  A hundred patients who underwent superficial parotidectomy were divided into 2 groups according to approach: Blair incision (57 cases) and modified facelift incision (43 cases). In the latter group, 36 patients were reconstructed with a superficial musculoaponeurotic system (SMAS) flap. During follow-up, patients were asked to rate their satisfaction with their postoperative appearance using a 1 to 3 scale.
  
  
  RESULTS
  Clinical Frey's syndrome was present in 8.5% of patients with SMAS flap, and in 19% patients without SMAS flap (p = 0.16). The average cosmetic outcome score for patients who underwent a modified facelift approach combined with an SMAS flap was 2.87, whereas patients whose tumors were approached through a Blair incision reported a lower score of 2.1 (p < 0.005).
  
  
  CONCLUSIONS
  A modified facelift incision combined with an SMAS flap improved the cosmetic appearance of patients who underwent extrafacial or superficial parotidectomy. In addition, this flap seems to reduce the occurrence of Frey's syndrome.
authors: Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, Spain; Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Spain. Electronic address: jvicente@uniovi.es.
authors: Juan Carlos
authors: JC
authors: de Vicente
authors: Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, Spain.
authors: Manuel
authors: M
authors: González-García
authors: Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, Spain.
authors: Lucas
authors: L
authors: de Villalaín
authors: Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, Spain.
authors: Álvaro
authors: Á
authors: Fernández-Valle
mesh_terms: D000235:Adenolymphoma / Q000601:surgery; D008949:Adenoma, Pleomorphic / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070606:Aponeurosis / Q000637:transplantation*; D016022:Case-Control Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*; D013547:Sweating, Gustatory / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
keywords: Frey's syndrome; Musculoaponeurotic system flap; Parotid gland; Parotidectomy; Rhytidectomy; Treatment outcome