Use of allogenic acellular dermal matrix in prevention of Frey's syndrome after parotidectomy

Abstract

Objective To evaluate the use of an allogenic acellular dermal matrix (ADM) as an interpositional graft to prevent Frey's syndrome after parotidectomy. Method We studied a total of 168 patients with benign parotid gland tumours, including 89 patients with pleomorphic adenoma; 45 with Warthin tumour; 17 with basal cell adenoma; and 17 with miscellaneous tumours. The patients were divided into two groups: the first (control n = 104) had superficial or partial parotidectomy alone, and the second (experimental n = 64), had superficial or partial parotidectomy with simultaneous placement of an ADM graft. All patients were evaluated for gustatory sweating by clinical examination. For objective assessment, 60 patients (30 from each group) were randomly selected for a starch-iodine test. Results Subjectively Frey's syndrome was recorded in 63 patients (61%) from the controls and one patient (2%) from the ADM group. Objectively Frey's syndrome was found in 24 patients from the control group (23%) and 2 patients from the ADM group (2%). Salivary fistulas developed in 18 patients from the control group (17%), but in only 1 patient from the ADM group (2%). Both differences were P < 0.05, but there was no significant difference between superficial parotidectomy and partial superficial parotidectomy ( P = 0.714). Conclusion The use of acellular dermal matrix (ADM) as an interpositional graft is an effective way of preventing Frey's syndrome after parotidectomy.