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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451809930
DOI: 10.1055/s-0045-1809930
Original Research

Aesthetic and Functional Outcomes After Superficial Parotidectomy – Comparison of Three Reconstruction Techniques: An Interventional Clinical Study

Authors

  • Sherif M. Askar 

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

  • Abd El-Raof Said

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

  • Tamer Oraby

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

  • Ibrahim Khaled

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

  • Mahmoud A. Megahed

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

  • Ali M. Awad 

    1   Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt

Funding The authors declare that they did not receive funding from agencies in the public, private, or non-profit sectors to conduct the present study.
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Abstract

Introduction

Preauricular defects is one of the main concerns after superficial parotidectomy. Plastic surgeons have described many filling techniques to overcome the problem.

Objective

To discuss and compare the esthetic and functional outcomes of three postsuperficial parotidectomy reconstruction techniques: partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel.

Methods

We included 29 adult patients submitted to reconstruction after superficial parotidectomy by partial-thickness, superiorly based sternocleidomastoid muscle flap, en-bloc fat grafting, and platelet-rich fibrin gel. A subjective evaluation of the overall facial appearance was conducted through a 5-point visual analog scale filled out by the patient, a close relative, and 3 blind staff members.

Results

Regarding the visual analog scale, in the comparison between the three groups (at the sixth and the twelfth months), the fat group reported the highest mean for satisfaction (3.4 ± 1.1 and 3.83 ± 0.97 respectively) and showed a highly-significant difference when compared to the sternocleidomastoid muscle flap and the platelet-rich fibrin gel groups (p = 0.0001 and 0.016 respectively).

Conclusion

Parotidectomy with immediate reconstruction of the surgical defect with an en-block fat graft provides better esthetic outcomes than sternocleidomastoid muscle flap and platelet-rich fibrin gel after 1 year. The sternocleidomastoid muscle flap and fat techniques resulted in minimal surgical-site morbidity and lower likelihood of developing Frey's syndrome. The fat graft yielded the best degree of cosmetic satisfaction with minimal morbidity. Fat overcorrection is recommended.

Level of Evidence: 4

Keywords

superficial parotidectomy - sternomastoid muscle flap - fat graft

Authors' Contributions

SMA and AE-RS: conceptualization, formal analysis, and writing – original draft; TO, IK, and AMA: data curation and writing – review & editing; and MAM: writing – review & editing. All authors have approved the final version to be published and have agreed to be accountable for all aspects of the work.


Ethical Approval

The present article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants followed the ethical standards of the institutional and/or national research committee and of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


Data Availability Statement

Data supporting the results of this study are available upon a reasonable request from the corresponding author.




Publication History

Received: 18 July 2023

Accepted: 03 May 2025

Article published online:
16 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Sherif M. Askar, Abd El-Raof Said, Tamer Oraby, Ibrahim Khaled, Mahmoud A. Megahed, Ali M. Awad. Aesthetic and Functional Outcomes After Superficial Parotidectomy – Comparison of Three Reconstruction Techniques: An Interventional Clinical Study. Int Arch Otorhinolaryngol 2025; 29: s00451809930.
DOI: 10.1055/s-0045-1809930