Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy

Abstract Background This study aimed to analyze the effects of anterior descending mandible (ADM) and free superficial musculoaponeurotic system (SMAS) folding flaps on post-parotidectomy facial depression. Methods This retrospective study examined the effects of sex, age, surgical sample size, meth...

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Main Authors: Xianda Chai, Xianxian Qian, Huan Wang, Ziqi Zhou, Lingling Tang, Jing Zhang, Longfei Yue
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-024-02670-2
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author Xianda Chai
Xianxian Qian
Huan Wang
Ziqi Zhou
Lingling Tang
Jing Zhang
Longfei Yue
author_facet Xianda Chai
Xianxian Qian
Huan Wang
Ziqi Zhou
Lingling Tang
Jing Zhang
Longfei Yue
author_sort Xianda Chai
collection DOAJ
description Abstract Background This study aimed to analyze the effects of anterior descending mandible (ADM) and free superficial musculoaponeurotic system (SMAS) folding flaps on post-parotidectomy facial depression. Methods This retrospective study examined the effects of sex, age, surgical sample size, method, duration, and blood loss on postoperative complications in 65 patients. Results No significant differences involving sex, age, or sample size for surgical resection were observed between the two groups. The incidence of Frey syndrome (P = 0.175) and the locations of facial nerve injuries and tumors were not significantly different between the two groups. However, a statistically significant difference was observed in postoperative facial depression between the groups (P = 0.045, P < 0.05). No significant difference was found between facial nerve injury and Frey’s sign in subgroup analysis of facial depression deformities. Within the facial depression group, tumor locations were significantly different (P = 0.021, P < 0.05). In the cases of facial depression after partial parotid resection, no significant difference was observed between ADM implantation and SMAS flap placement. A significant difference was noted between the ADM implantation and SMAS flap groups in the total parotidectomy group (P = 0.046 and P < 0.05, respectively). Conclusion Women are more likely to experience facial depression after parotid surgery. Facial depression is most likely to occur after parotid resection if the tumor is located in the deep lobes of the parotid gland. The use of SMAS flaps can prevent facial depression, and both ADM and SMAS flaps can prevent Frey’s syndrome. Partial parotid resection reduces the risk of facial nerve injury and facial depression.
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spelling doaj-art-f5496bf5fb3148b2b1ec416fa585f5c62025-08-20T02:12:57ZengBMCBMC Surgery1471-24822024-11-012411810.1186/s12893-024-02670-2Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomyXianda Chai0Xianxian Qian1Huan Wang2Ziqi Zhou3Lingling Tang4Jing Zhang5Longfei Yue6Oral and Maxillofacial Surgery, People’s Hospital of Anshun CityOral and Maxillofacial Surgery, People’s Hospital of Anshun CityOral and Maxillofacial Surgery, People’s Hospital of Anshun CityOral and Maxillofacial Surgery, People’s Hospital of Anshun CityOral and Maxillofacial Surgery, People’s Hospital of Anshun CityOral and Maxillofacial Surgery, People’s Hospital of Anshun CityGeneral Practice, People’s Hospital of Anshun CityAbstract Background This study aimed to analyze the effects of anterior descending mandible (ADM) and free superficial musculoaponeurotic system (SMAS) folding flaps on post-parotidectomy facial depression. Methods This retrospective study examined the effects of sex, age, surgical sample size, method, duration, and blood loss on postoperative complications in 65 patients. Results No significant differences involving sex, age, or sample size for surgical resection were observed between the two groups. The incidence of Frey syndrome (P = 0.175) and the locations of facial nerve injuries and tumors were not significantly different between the two groups. However, a statistically significant difference was observed in postoperative facial depression between the groups (P = 0.045, P < 0.05). No significant difference was found between facial nerve injury and Frey’s sign in subgroup analysis of facial depression deformities. Within the facial depression group, tumor locations were significantly different (P = 0.021, P < 0.05). In the cases of facial depression after partial parotid resection, no significant difference was observed between ADM implantation and SMAS flap placement. A significant difference was noted between the ADM implantation and SMAS flap groups in the total parotidectomy group (P = 0.046 and P < 0.05, respectively). Conclusion Women are more likely to experience facial depression after parotid surgery. Facial depression is most likely to occur after parotid resection if the tumor is located in the deep lobes of the parotid gland. The use of SMAS flaps can prevent facial depression, and both ADM and SMAS flaps can prevent Frey’s syndrome. Partial parotid resection reduces the risk of facial nerve injury and facial depression.https://doi.org/10.1186/s12893-024-02670-2Parotid tumorAnterior descending mandible (ADM)Superficial musculoaponeurotic system (SMAS)Facial concave deformityFrey syndrome
spellingShingle Xianda Chai
Xianxian Qian
Huan Wang
Ziqi Zhou
Lingling Tang
Jing Zhang
Longfei Yue
Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
BMC Surgery
Parotid tumor
Anterior descending mandible (ADM)
Superficial musculoaponeurotic system (SMAS)
Facial concave deformity
Frey syndrome
title Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
title_full Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
title_fullStr Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
title_full_unstemmed Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
title_short Comparative analysis of free SMAS fold flap and ADM in facial depression after parotidectomy
title_sort comparative analysis of free smas fold flap and adm in facial depression after parotidectomy
topic Parotid tumor
Anterior descending mandible (ADM)
Superficial musculoaponeurotic system (SMAS)
Facial concave deformity
Frey syndrome
url https://doi.org/10.1186/s12893-024-02670-2
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