Prevention of Frey syndrome with superficial temporal fascia interpositioning: a retrospective study

Frey syndrome (FS) is a commonly documented postoperative complication following parotidectomy. The aim of this study was to clinically evaluate the efficacy of superficial temporal fascia (STF) as interpositioning barrier between the overlying skin flap and the parotid bed for the prevention of FS following superficial parotidectomy. A retrospective study was designed involving a population of patients from a single institution who underwent superficial parotidectomy for parotid tumours and refractory chronic sialadenitis from 2008 to 2011. Forty-eight cases were identified and divided into two groups: group I (n = 25) had undergone STF interpositioning between the skin flap and the parotid bed after extending the modified Blair's incision in the temporal region, and group II (n = 23) had undergone a superficial parotidectomy using the modified Blair's incision without any interpositioning. In group I, one of 25 cases (4%) developed mild FS; in group II, nine of 23 cases (39.1%) developed FS of varying severity. There were no cases of permanent facial palsy in either group. Alopecia along the temporal extension of the incision line was imperceptible in all group I cases. The use of an STF interpositioning barrier between the overlying skin flap and the parotid bed is a safe and effective procedure for the prevention of FS following superficial parotidectomy.