Surgical outcome of modified versus conventional parotidectomy in treatment of benign parotid tumors

BACKGROUND: Our proposed modified technique includes creating a posterior pedicle parotid gland fascia flap without separating the great auricular nerve branches through an aesthetic incision. This fascial flap is sutured back to the parotid bed creating a barrier of the aberrant regeneration of sympathetic fibers thus, theoretically, decreasing the incidence of Frey's syndrome. PATIENTS AND METHODS: Superficial parotidectomy for benign parotid neoplasms was carried out using either the conventional (Group 1) or modified (Group 2) technique. Outcomes of the two groups were reviewed. Both techniques were compared for the cosmetic outcome, great auricular nerve anesthesia, and the incidence of Frey's syndrome. RESULTS: The incision in the modified group was more cosmetic both subjectively and objectively. Postoperatively, transient numbness was reported by 21% of cases in the modified group. In the control group, transient sensory deficit was complained by all cases. Fourteen patients restored sensation completely within 2 years after surgery. The incidence of subjective Frey's syndrome was significantly lower in the modified group. Objectively, on starch iodine test, the incidence of Frey's syndrome was higher in both groups. CONCLUSION: In selected cases of benign parotid neoplasm, modified parotidectomy is an effective technique in improving the outcome of the procedure.