Superficial and deep parotidectomies are known treatments for benign and malignant neoplasms of parotid glands. Due to the gland's proximity to facial nerve and other vital structures, this surgery carries the highest risk of facial nerve palsy. Another frequently overlooked complication, which can be detrimental to patient's life style is Frey's syndrome, or gustatory sweating. Other complications include flap necrosis and various contour deformities. We conducted this study on a group of 40 patients of parotid swellings to assess usage of sternocleidomastoid flap in prevention of Frey's syndrome, contour deformities, flap necrosis, salivary fistula and drain related injuries. We divided the patients in two groups based on the usage of sternomastoid flap. In Group A, the patients underwent superficial or total parotidectomies with a partial thickness, superiorly based sternomastoid flap. In Group B, no sternomastoid flap was placed. The incidence of Frey's syndrome was seen to be 3 times in Group B, while a visible contour deformity was seen in a third of patients in Group B, with Group A reporting no incidence. Also Group A, did not see any cases of flap necrosis or salivary fistula, while Group B saw 3 and 2 cases respectively. Also, among the two revision cases done in Group A, the one with previously placed sternomastoid flap (done by us 3 years back) had an excellent plane preserved, while another revision case without sternomastoid flap saw a complete adherence of facial nerve to overlying skin, resulting in Grade II permanent facial palsy. Parotidectomy is a technically challenging surgery in regards to important structures in the vicinity. Even with ostensibly perfect technique, facial nerve injury can occur for unknown reasons. All in all, sternomastoid flap is an acceptable modality to fill the parotidectomy defect, improve the facial contour and reduce the incidences of Frey's syndrome and skin necrosis.
<p class="abstract"><strong>Background:</strong> The aim of our study is comparison of effectiveness of cartilage (conchal or tragal) tympanoplasty with temporalis fascia tympanoplasty in terms of graft uptake and audiological outcomes. Help of following databases were taken: MEDLINE, emedicine, Google scholar, and the PubMed.</p><p class="abstract"><strong>Methods:</strong> We studied the outcome of two different type of graft material (cartilage and temporalis fascia). Who underwent type 1 tympanoplasty at department of otorhinolaryngology, RUHS College of Medical Sciences, Jaipur from November 2015 to November 2018. Total 80 patients were divided in two groups, 40 patients underwent cartilage grafting while 40 patient’s tympanoplasty was done using temporalis fascia graft. </p><p class="abstract"><strong>Results:</strong> The successful graft uptake rate for the fascia group was 90%, and that for the cartilage group was 97.5%. Though initial audiological improvements were better in fascia graft group, long term results were similar in both groups.</p><p class="abstract"><strong>Conclusions:</strong> The use of cartilage tympanoplasty has similar outcomes to temporalis fascia grafting for audiological purpose. But successful uptake rate is better for cartilage as it is elastic, more resistant to resorption and retraction from more negative middle ear pressure.</p>
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