title: The superficial musculoaponeurotic system flap in the prevention of Frey syndrome: A meta-analysis.
abstract: Evaluate the difference of the incidence in clinical Frey syndrome in studies comparing classical parotidectomy and parotidectomy with superficial musculoaponeurotic system (SMAS) flap elevation and suturing through meta-analysis methodology.
  
  
  
  Meta-analysis of controlled studies with and without SMAS flap.
  
  
  
  Database search with the following key word combination: "Frey syndrome" and "SMAS."
  
  
  
  parotidectomy, SMAS flap and control groups, minimal follow-up of 1 year. The outcome was the presence of clinical Frey syndrome.
  
  
  
  Eleven studies, mostly retrospective and not randomized. According to the fixed-effect model, SMAS technique is associated with a decrease of clinical Frey syndrome with an odds ratio (OR) of 0.42 (confidence interval [CI] 0.32-0.56). With the random-effect model, the difference remains significant (P = 0.006) with an OR of 0.25 (CI 0.09-0.66). The heterogeneity index I(2) is very high (85%).
  
  
  
  The use of SMAS flap and suturing is associated with a decreased incidence of Frey syndrome. Laryngoscope, 126:1581-1584, 2016.
authors.affiliation: Department of Oto-Rhino-Laryngology Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dulguerov
authors.affiliation: Medical School, Geneva University, Geneva, Switzerland.
authors.forename: Amir
authors.initials: A
authors.lastname: Makni
authors.affiliation: Department of Oto-Rhino-Laryngology Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Pavel
authors.initials: P
authors.lastname: Dulguerov
mesh_terms: D000068456:Clinical Studies as Topic; D006801:Humans; D010305:Parotid Diseases / Q000601:surgery; D035421:Parotid Region / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D000069259:Superficial Musculoaponeurotic System / Q000637:transplantation*; D013524:Surgical Flaps / Q000601:surgery*; D013547:Sweating, Gustatory / Q000209:etiology / Q000517:prevention & control*
keywords: Frey syndrome; Parotidectomy; SMAS; gustatory sweating; meta-analysis; prevention