(0702) Post-Parotidectomy Reconstruction: A Systematic Review on Methods and Their Outcomes Regarding Overall Cosmesis

Introduction: Parotidectomy is a widely performed procedure for many different pathologies and may include extensive resections resulting in large ipsilateral contour deformities and facial asymmetry. There are many options for reconstruction, but to the best of our knowledge, no comprehensive reviews on the reconstruction option chosen and their outcomes, particularly pertaining to postoperative cosmesis, have been performed.

Methods: A systematic review was performed using the PRISMA recommendations. Data sources included PubMed, EBSCO, and Scopus, which were initially queried March 31, 2023. Initial data obtained included literature from 1841 through 2023. Articles were categorized based on types of reconstructive efforts employed. Qualitative and descriptive analyses of studies and outcomes data were performed.

Results: In total, 75 articles met inclusion criteria. The indications for reconstruction method employed included, but were not limited to size of resultant post-parotidectomy defect, skin or facial nerve resection, and physician preference and/or experience. The most utilized reconstructive procedures include sternocleidomastoid (n = 218, 36 inferiorly-based) and superficial musculo-aponeurotic system (n = 339, many paired with adjuvant procedures) flaps, and dermal fat grafts (n = 402). The vast majority of patients were satisfied with their cosmetic outcome regarding facial contour. Microvascular free flaps, especially anterolateral thigh, are predominantly preferred for substantial defects. Many other reconstructive measures are discussed and reviewed. Secondary results include reconstructive choice regarding facial nerve injury or sacrifice and the presence of Frey’s Syndrome.

Conclusions: This systematic review explores approaches to post-parotidectomy reconstruction. Consistently high patient satisfaction is observed regarding cosmetic outcomes across diverse reconstructive techniques. This study offers insights into the selection of reconstruction methods, enhancing our understanding of their effectiveness and patient satisfaction.