INTRODUCTION
The approximately 80% of parotid tumors are benign tumor, and surgical removal is the primary treatment for parotid tumors. (1) Benign tumors are commonly located in the superficial lobe. Complete excision of benign parotid tumors with an adequate margin of normal tissue is recommended, resulting in partial superficial, superficial, or even subtotal and total parotidectomy. (2, 3)
This parotid surgery has several adverse effects, including facial palsy, sialocele or salivary fistula, sensory deficit, Frey’s syndrome (FS), scars, and facial depression. (4, 5) Normally, the majority of facial palsy were temporary facial paresis. FS is common complication with affecting the quality of life. FS, also known as Gustatory Sweating syndrome, is characterized by gustatory sweating and gustatory flushing. (6) The incidence of FS has been reported in many articles with variable percentages. The overall average for FS is between 12.5% and 62% for subjective method and 86% to 98% when objective testing is performed with Minor’s Starch-Iodine Test. (7, 8) Some patients report even having distressing symptoms. (9) Botulinum toxin A has been proved effective in the treatment of FS,7 however, its therapeutic modalities are rarely permanent in efficacy. (10) So, the trends of treatment have been build a barrier between skin and parotid gland. (8, 11)
The facial depression in the periauricular and retromandibular areas were almost unavoidable with the removal of the parotid gland and tumors, which causing apparent asymmetry. The leads low aesthetic score, particularly in young people and those benign tumor patients. (12, 13) So, the areas need to be reconstructed with other tissues.
Some previous study have reported a variety of measures to prevent FS and the facial depression in the periauricular and retromandibular areas, such as a sternocleidomastoid, superficial muscular aponeurotic system, vascularized free flap, temporoparietal fascial flap,
the free or vascularized dermal-fat graft, etc. (14-16) Those measures have its advantages and disadvantages. (11)
Acellular dermal matrix (ADM) can act as a biological scaffold for re-epithelialisation, neovascularisation, and infiltration of fibroblasts, but it does not produce an immune response. (17) It acts as an ideal alternative for tissue augmentation and barrier to preventing FS and facial depression after parotidectomy. (18, 19) The purpose of the present retrospective study was to investigate the complications and aesthetic effects of ADM after parotidectomy.