Reconstruction using sternocleidomastoid muscle flap versus posterior belly of digastric muscle flap compared with no re
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ORIGINAL ARTICLE
Reconstruction using sternocleidomastoid muscle flap versus posterior belly of digastric muscle flap compared with no reconstruction following superficial parotidectomy Anshul Rai 1 & Anuj Jain 2,3
&
Abhay Datarkar 4 & Dakhshata Kawadkar 5
Received: 25 March 2020 / Accepted: 11 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The most common complications following superficial parotidectomy are formation of contour deformity and development of Frey’s syndrome. Multiple modalities are being used to prevent these complications. We hereby intend to compare the reconstruction modalities (sternocleidomastoid (SCM) muscle flap, posterior belly of digastric (PBD) muscle flap) with) No reconstruction (NR) following superficial parotidectomy. Materials and methods A comparative study was designed which included 15 patients requiring parotidectomy. These patients were divided into three groups viz. SCM, PBD, and NR. The functional outcome (facial nerve involvement, Frey syndrome, ear lobule sensation, neck movements) and the esthetic results were evaluated subjectively and objectively. The outcomes were statistically evaluated using chi-square test and ANOVA test. Results Facial nerve palsy occurred in 2 cases in each group, and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 1 patient in the SCM group, in 2 patients in the PBD group, and in 4 patients in the NR group; only 1 patient of PBD group and 3 patients of NR group complained of gustatory sweating. Neck movements were unaffected in the PBD and NR groups; however, 1 patient complained of mild discomfort and pain during neck movements in the SCM group. Conclusion Primary closure showed the worst results regarding cosmetic deformity. Hence, it is recommended to mandatorily reconstruct the defect. However, the sternocleidomastoid muscle flap is a better cosmetic option compared with posterior belly of digastric muscle flap. In cases with larger defects, a combination of both the flaps can be used. SCM flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve and mildly affected neck movements. Keywords Parotidectomy . Sternocleidomastoid muscle flap . Posterior belly of digastric muscle flap . Frey syndrome . Contour deformity
Introduction * Anuj Jain [email protected] 1
Department of Dentistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
2
Consultant Oral and Maxillofacial Surgeon, Nagpur, Maharashtra, India
3
Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
4
Department of Oral and Maxillofacial Surgery, Government Dental College, Nagpur, Maharashtra, India
5
Department of Oral Pathology, Rishiraj Dental College, Bhopal, Madhya Pradesh, India
The benign and malignant tumors of the parotid gland require management in the form of parotidectomy, either superficial or total. Howe
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