This is a retrospective study from Naples, Italy. The authors compare patients with benign parotid disease that were reconstructed with three different techniques. In total 224 patients between February 2002 and March 2009 were included; these patients had either formal superficial parotidectomy or extra capsular dissection and were reconstructed by superficial musculoaponeurotic system (SMAS) flap, sternocleidomastoid (SCM) muscle flap or a temporoparietal fascia (TPF) flap. The surgical approach was a modified facelift and only patients with pleomorphic adenoma or Warthin tumours were included. The authors conclude all three reconstructive techniques drastically reduce post-parotidectomy Frey’s syndrome. There is some discussion of the raising of the three flaps but it is limited. They advise the SMAS flap to reconstruct in middle aged patients, the SCM in patients with recurring neoplastic disease and the TPF flap in other patients. It would be interesting to check a similar number of patients with no reconstruction and compare their outcomes, especially quality of life. Similarly it would be interesting to gather data on the numbers of surgeons that perform immediate reconstruction and if it is indicated.

Reconstructive techniques of the parotid region.
Orabona GD, Salzano G, Petrocelli M, et al.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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