Different Surgical Strategies in the Prevention of Frey Syndrome: A Systematic Review and Meta-analysis.
Acellular Dermis
Adult
Bayes Theorem
Fascia
/ transplantation
Humans
Incidence
Middle Aged
Neck Muscles
/ surgery
Network Meta-Analysis
Parotid Gland
/ surgery
Postoperative Complications
/ epidemiology
Plastic Surgery Procedures
/ methods
Superficial Musculoaponeurotic System
/ surgery
Surgical Flaps
/ surgery
Sweating, Gustatory
/ epidemiology
Treatment Outcome
Parotidectomy
acellular dermal matrix
free fat graft
temporoparietal fascia
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
17
12
2020
received:
27
10
2020
accepted:
12
01
2021
pubmed:
28
1
2021
medline:
27
7
2021
entrez:
27
1
2021
Statut:
ppublish
Résumé
To define the best surgical technique able to reduce Frey syndrome (FS) incidence after parotidectomy. Systematic review and network meta-analysis. An arm-based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were the incidence of subjective (clinical) and objective (positive starch-iodine test result) FS, respectively. A total of 3830 patients with a median age of 50.35 years (n = 2323; IQR 44.25-54.18) were included for six interventions [temporoparietal fascia (TPFF), free fat graft (FFG), acellular dermal matrix (ADM), sternocleidomastoid muscle (SCM) flap, and superficial musculoaponeurotic system (SMAS) flap]. If compared to no treatment, the greatest reduction of subjective (clinical) FS incidence was measured for the TPFF (OR: 0.07, CI: 0.004-0.57), the ADM (OR: 0.09, CI: 0.02-0.35), and the FFG (OR: 0.11, CI: 0.03-0.42) techniques. However, a significant difference was measured also for the SCM flap (OR: 0.38, CI: 0.18-0.73) and for the SMAS flap (OR: 0.42, CI: 0.19-0.97). All treatments showed a significant reduction of the objective FS incidence if compared to no treatment (FFG, OR: 0.06, CI: 0.002-0.62; TPFF, OR: 0.07, CI: 0.01-0.33; ADM, OR: 0.11, CI: 0.03-0.44; SMAS, OR: 0.36, CI: 0.17-0.71; SCM, OR: 0.40, CI: 0.19-0.74). TPFF, ADM, and FFG seem to be the best treatment strategies to prevent FS after parotidectomy. Further randomized controlled trials comparing these techniques should be conducted to define specific indications. Laryngoscope, 131:1761-1768, 2021.
Types de publication
Comparative Study
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1761-1768Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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