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.