Sternocleidomastoid muscle flap in preventing Frey's syndrome after parotidectomy: A systematic review

Authors

  • Alvaro Sanabria MD, MSc, PhD,

    1. Department of Surgery, Universidad de La Sabana-Fundacion Abood Shaio, Bogota, Colombia
    Search for more papers by this author
  • Luiz P. Kowalski MD, PhD,

    1. Department Otorhinolaryngology–Head and Neck Surgery, Centro de Tratamento e Pesquisa Hospital do Cancer A.C. Camargo, São Paulo, Brazil
    Search for more papers by this author
  • Patrick J. Bradley MB, BCh, BAO, DCH, MBA, FRCS (Ed, Eng, Ir), FHKCORL, FRCSLT (Hon), FRACS (Hon),

    1. Department of Otolaryngology–Head and Neck Surgery, Nottingham University Hospital, Queens Medical Centre, Nottingham, United Kingdom
    Search for more papers by this author
  • Dana M. Hartl MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France
    2. Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France
    Search for more papers by this author
  • Carol R. Bradford MD,

    1. Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
    Search for more papers by this author
  • Remco de Bree MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
    Search for more papers by this author
  • Alessandra Rinaldo MD, FRCSEd ad hominem, FRCS (Eng, Ir) ad eundem, FRCSGlasg,

    1. Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy
    Search for more papers by this author
  • Alfio Ferlito MD, DLO, DPath, FRCSEd ad hominem, FRCS (Eng, Glasg, Ir) ad eundem, FDSRCS ad eundem, FHKCORL, FRCPath, FASCP, IFCAP

    Corresponding author
    1. Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy
    • Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy
    Search for more papers by this author

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.

Conclusion

Current reported evidence is inconclusive as to the use of SCM muscle flap as an intervention to prevent Frey's syndrome following parotid surgery. © 2011 Wiley Periodicals, Inc. Head Neck, 2012

Ancillary