The superficial musculoaponeurotic system flap in the prevention of Frey syndrome: A meta-analysis

Abstract

The use of SMAS flap and suturing is associated with a decreased incidence of Frey syndrome. Laryngoscope, 126:1581-1584, 2016.

Evaluation and Treatment of Frey Syndrome

“…It presents with gustatory sweating and flushing of the skin on the lateral aspect of the face and upper neck, which corresponds to the area of distribution of the auriculotemporal nerve [14]. Several surgical techniques are utilized to prevent development of FS aiming to provide a barrier between the skin and surgical field [6].…”

“…Surgical treatment options including transection of the auriculotemporal nerve, tympanic nerve, and greater auricular nerve, are also described in the literature although they are less commonly practiced for the management of FS. studies indicate that these preventive surgical procedures are associated with a decrease in the clinical symptoms of FS [14][15][16][17][18]. However, there are also several others, which found no evidence of such an association [19,20].…”

“…In order to avoid FS, several surgical preventive methods are described aiming to create a barrier between the parotidectomy bed and the skin [14]. These methods are increased skin thickness flaps, local fascia or muscle flaps, such as sternocleidomastoid muscle flap (SCMMF), superficial musculoaponeurotic system (SMAS) flap, platysma muscle flap, or temporal muscle fascia flap, or the use of acellular dermal matrix or free fat grafts [6,14] …”

“…These methods are increased skin thickness flaps, local fascia or muscle flaps, such as sternocleidomastoid muscle flap (SCMMF), superficial musculoaponeurotic system (SMAS) flap, platysma muscle flap, or temporal muscle fascia flap, or the use of acellular dermal matrix or free fat grafts [6,14] …”

Temporoparietal frey syndrome: An uncommon variant of a common syndrome

“…Other methods for prevention of Frey syndrome include recreating barriers between the nerve fibers by using nearby muscle tissue. These include interposition grafts with a superficial musculoaponeurotic system 24,25 or sternocleidomastoid muscle. 26,27 Another common method of barrier reconstruction is use of acellular human dermal matrix.…”