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

https://doi.org/10.17650/2222-1468-2023-13-4-19-26

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.

About the Authors

A. A. Boyko
Leningrad Regional Clinical Hospital
Russian Federation

Alexander Alexandrovich Boyko

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



A. V. Karpenko
Leningrad Regional Clinical Hospital
Russian Federation

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



R. R. Sibgatullin
Leningrad Regional Clinical Hospital
Russian Federation

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



O. M. Nikolaeva
Leningrad Regional Clinical Hospital
Russian Federation

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



E. O. Levchenko
Leningrad Regional Clinical Hospital
Russian Federation

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



A. S. Kucherenko
Leningrad Regional Clinical Hospital
Russian Federation

194291; Lit. A, Bld. 1, 45 Lunacharskogo Prospekt; Saint Petersburg



M. A. Karpuschenko
Medi Prof
Russian Federation

192288;  Lit. A, 47 Dunajskij Prospekt; Saint Petersburg



References

1. Neuber F. Fat transplantation. Chir Kongr Verhandl Dsch Gesellch Chir 1893;22:66. (In German).

2. Wang K.-Y., Yang Z., Wang W.-L. et al. Autologous free fat graft for repair of concave deformity after total parotidectomy. J Craniofac Surg 2019;30(3):834–7. DOI: 10.1097/SCS.0000000000005178

3. Solntsev A.M., Kolesov V.S., Kolesova N.A. Diseases of the salivary glands. Kiyev, 1991. 312 p. (In Russ.).

4. Debets J.M., Munting J.D. Parotidectomy for parotid tumours: 19-year experience from The Netherlands. Br J Surg 1992;79(11):1159–61. DOI: 10.1002/bjs.1800791116

5. Satko I., Stanko P., Longauerova I. Salivary gland tumours treated in the stomatological clinics in Bratislava. J Craniomaxillofac Surg 2000;28(1):56–61. DOI: 10.1054/jcms.1999.0092

6. Freedberg A., Shaw R., McManus J. The auriculotemporal syndrome. A clinical and pharmacologic study. J Clin Invest 1948;27(5):669–76. DOI: 10.1172/JCI102015

7. Drummond P.D. Mechanisms of gustatory flushing in Frey’s syndrome. Clin Auton Res 2002;12(3):144–6. DOI: 10.1007/s10286-002-0042-x

8. Neumann A., Rosenberger D., Vorsprach O. et al. The incidence of Frey syndrome following parotidectomy: results of a survey and follow-up. HNO 2011;59(2):173–8. DOI: 10.1007/s00106-010-2223-6

9. Lastovka A.S. Prevention of the development of Frey syndrome during the removal of benign tumors of the parotid gland. Modern Dentistry 2018;2:76–8. (In Russ.).

10. Аl-Naqeeb N.I., Dashti H., al-Muhanna A.H., Behbehani A. Parotid gland tumours: a 15-year experience. J Roy Coll Surg Edinb 1992;37(2):89–93.

11. Emodi O., El-Naaj I.A. , Gordin A. et al. Superficial parotidectomy versus retrograde partial superficial parotidectomy in treating benign salivary gland tumour-pleomorphic adenoma. J Craniomaxillofac Surg 2006;34(S1):39–40. DOI: 10.1016/j.joms.2009.09.075

12. Papadogeorgakis N., Skouteris C.A., Mylonas A.I., Angelopoulos A.P. Superficial parotidectomy: technical modifications based on tumour characteristics. J Craniomaxillofac Surg 2004;32(6): 350–3. DOI: 10.1016/j.jcms.2004.05.004

13. Fee W.E., Tran L.E. Functional outcome after parotidectomy. Laryngoscope 2004;114(2):223–6. DOI: 10.1097/00005537-200402000-00009

14. Dulguerov P., Quinodoz D., Cosendai G. et al. Prevention of Frey’s syndrome during parotidectomy. Arch Otolaryngol Head Neck Surg 1999;125(8):833–9. DOI: 10.1001/archotol.125.8.833

15. Garcia-Perla A., Muñoz-Ramos M., Infante-Cossio P. et al. Pleomorphic adenoma of the parotid in childhood. J Craniomaxillofac Surg 2002;30(4):242–5. DOI: 10.1054/jcms.2002.0306

16. Meningaud J.P., Bertolus C., Bertr J.C. Parotidectomy: assessment of a surgical technique including facelift incision and SMAS advancement. J Craniomaxillofac Surg 2006;34(1):34–7. DOI: 10.1016/j.jcms.2005.08.007

17. Peer L.A. Loss of weight and volume in human fat grafts with postulation of a ‘‘Cell Survival Theory’’. Plast Reconstr Surg 1950;5:217–30.

18. Yoshimura K., Eto H., Kato H. et al. Invivo manipulation of stem cells for adipose tissue repair/reconstruction. Regen Med 2011;6(Suppl. 6):33–41. DOI: 10.2217/rme.11.62

19. Pu L.L. Mechanisms of fat graft survival. Ann Plast Surg 2016;77(Suppl. 1):S84. DOI: 10.1097/SAP.0000000000000730

20. Rohrich R.J., Sorokin E.S., Brown S.A. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg 2004;113(1):391–5. DOI: 10.1097/01.PRS.0000097293.56504.00

21. Ullmann Y., Hyams M., Ramon Y. et al. Enhancing the survival of aspirated human fat injected into nude mice. Plast Reconstr Surg 1998;101(7):1940–4. DOI: 10.1097/00006534-199806000-00026

22. Curry J.M., Fisher K.W., Heffelfinger R.N. et al. Superficial musculoaponeurotic system elevation and fat graft reconstruction after superficial parotidectomy. Laryngoscope 2008;118(2):210–5. DOI: 10.1097/MLG.0b013e3181581f94

23. Conger B.T., Gourin C.G. Free abdominal fat transfer for reconstruction of the total parotidectomy defect. Laryngoscope 2008;118(7):1186–90. DOI: 10.1097/MLG.0b013e31816dd2e9

24. Nosan D.K., Ochi J.W., Davidson T.W. Preservation of facial contour during parotidectomy. Otolaryngol Head Neck Surg 1991;104(3):293. DOI: 10.1177/019459989110400302

25. Harada T., Inoue T., Harashina R. et al. Dermisfat graft after parotidectomy to prevent Frey’s syndrome and the concave deformity. Ann Plast Surg 1993;31(5):450–2. DOI: 10.1097/00000637-199311000-00012

26. Conley J.J., Clairmont A.A. Dermal-fat-fascia grafts. Otolaryngol 1978;86(4 Pt. 1):641–9. DOI: 10.1177/01945998780860s420

27. Loyo M., Gourin C.G. Free abdominal fat transfer (FAT) for partial and total parotidectomy defect reconstruction. Laryngoscope 2016;126(12):2694–8. DOI: 10.1002/lary.26025


Review

For citations:


Boyko A.A., Karpenko A.V., Sibgatullin R.R., Nikolaeva O.M., Levchenko E.O., Kucherenko A.S., Karpuschenko M.A. The use of derma-fat grafts to eliminate defects during operations on the parotid glands. Head and Neck Tumors (HNT). 2023;13(4):19-26. (In Russ.) https://doi.org/10.17650/2222-1468-2023-13-4-19-26

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ISSN 2222-1468 (Print)
ISSN 2411-4634 (Online)