The use of derma-fat grafts to eliminate defects during operations on the parotid glands

Abstract

Introduction. The effectiveness of surgical treatment of parotid gland tumors is determined by the frequency of local relapse and functional and aesthetic results, which are determined not only by the anatomical and functional safety of the facial nerve. It is also very important to level aesthetic deformities of the parotid region and reduce the severity of frey’s syndrome. Aim. To retrospectively analyze the use of dermal fat grafts to correct defects during operations on the parotid glands. Materials and methods. Our study included 7 patients (2 men and 5 women) who were treated at the Leningrad Regional Clinical Oncology Dispensary named after L. D. Roman from 2021 to 2022. The average age of the patients was 49.7 years (42–64 years), the average follow-up period was 20.4 months (19–22 months). All patients underwent total / subtotal resection of the parotid gland; we used an abdominal dermal fat graft to close the defect. Histological examination of the surgical material revealed a pleomorphic adenoma of the parotid gland in 5 cases; in 2 cases, a ma-lignant tumor (adenocystic carcinoma and basal cell carcinoma of the salivary glands), which required adjuvant radiation therapy in radical doses. To assess aesthetic and functional results in the recipient and donor areas, we developed and used a questionnaire. Results. 6–8 months after the end of treatment, 5 patients completed questionnaires. 4 people indicated complete symmetry of the face, one patient indicated an average depression. 3 patients did not note any pain in the parotid area, 2 patients had minor discomfort that did not cause any problems. Only one respondent noted redness of the face when eating, which did not cause him any problems; the rest of the survey participants did not find these changes. None of the survey participants noted the appearance of sweat on their face when eating. Conclusion. The use of dermal fat grafts can improve the aesthetic and functional results of treatment in patients undergoing operations on the parotid glands. This technique is quite easy to use and does not significantly increase the time of surgical intervention. A derma-fat graft does not make it difficult to monitor disease relapses.