Platysma muscle-cervical fascia-sternocleidomastoid muscle (PCS) flap for parotidectomy

• Published in: Head & neck Vol. 21; no. 5; pp. 428 - 433
• Main Authors: Kim, Steven Yun, Mathog, Robert H.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01-08-1999; John Wiley & Sons
• Subjects: Adenoma, Pleomorphic - surgery; Adult; Biological and medical sciences; Cheek; Facial Muscles; Female; Frey's syndrome; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Medical sciences; Otorhinolaryngology. Stomatology; Parotid Gland - surgery; Parotid Neoplasms - surgery; parotid tumors; parotidectomy; Patient Satisfaction; platysma muscle; Postoperative Complications - etiology; Postoperative Complications - prevention & control; sternocleidomastoid muscle; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surgical Flaps; Sweating, Gustatory - etiology; Sweating, Gustatory - prevention & control; Treatment Outcome; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Human; Nervous system diseases; Parotid gland; Stomatology; Parotidectomy; Fasciocutaneous flap; Malignant tumor; Peripheral neuropathy; Retrospective; Result; Prevention; Salivary gland disease; Cranial nerve disease; Gustatory sweating; Treatment; Platysma muscle; Surgery; Sternocleidomastoid muscle; ENT disease; Complication; Musculocutaneous flap; Technique; Benign neoplasm; Comparative study
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/(SICI)1097-0347(199908)21:5<428::AID-HED8>3.0.CO;2-3

Background
Parotidectomy is useful in the treatment of benign and malignant neoplasms of the parotid gland, but often leads to sequelae of facial deformity and Frey's syndrome. This paper presents a retrospective review of parotidectomy results in 21 consecutive patients treated with either traditional techniques or with the rotation and advancement of combined platysma muscle‐cervical fascia‐sternocleidomastoid flap (PCS).
Methods
The surgical procedures utilized for removal and reconstruction are described. Information on appearance and function was obtained by analysis of hospital and office records and telephone questionnaire for patients with and without the flap.
Results
Of the 21 patients eligible for this study, only 9 of 10 patients with the PCS flap and 10 of 11 patients without the flap provided sufficient data for analysis. In the flap group all 9 patients either noted a mild fullness on the operated side or no difference between sides. In the nonflap group, 4 patients felt they had a moderate depression, 2 patients noted a mild depression, and 4 patients noted no difference between sides. Frey's syndrome was classified as mild in 2 patients in the PCS group, whereas in the nonflap group, 4 patients thought it was mild and 1, severe. Complications were rare in either group.
Conclusion
The PCS flap prevents deformity and contributes to patient satisfaction following parotidectomy. The flap helps to prevent Frey's syndrome and is not associated with an increase in postoperative complications. The flap is recommended following removal of nonrecurrent or low‐grade malignant parotid tumors. © 1999 John Wiley & Sons, Inc. Head Neck 21: 428– 433, 1999.