The most dreaded complication of parotidectomy is facial nerve injury which is fortunately rare. A less devastating consequence that occurs in some patients is a pre-auricular depression caused by the absence of the parotid gland. While the problem is cosmetic, patients may feel uncomfortable with their appearance.
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August 2016
Two-week postoperative visit showing overcorrection of a right (A, B) and left (C, D) parotidectomy defect with free abdominal fat transfer reconstruction.
A number of surgical techniques to reconstruct this parotidectomy defect are available, including bipedicled sternocleidomastoid (SCM) muscle flaps, AlloDerm biomaterial, free tissue transfer, and free abdominal fat transfer (FAT). A recent study published in The Laryngoscope examines the use and effectiveness of the FAT transfer in reconstruction, including a realistic look at complication rates. The investigators say the procedure is technically simple and, when performed at the time of parotidectomy, improves facial symmetry and achieves excellent postoperative cosmetic results. (Laryngoscope [published online ahead of print May 30, 2016]. doi: 10.1002/lary.26025).
FAT Graft Procedure
In the study, 105 patients underwent 108 parotidectomies with FAT reconstruction between 2007 and 2015. The majority of patients had benign pathology and tumors that were smaller than 3 cm. Superficial parotidectomy was performed in 62 patients, and concurrent elective neck dissection was performed in eight patients.