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Intra‑auricular modification of facelift incision decreased the risk of Frey syndrome

Chih‑Ying Chena, Peir‑Rong Chena,b, Yu‑Fu Choua,b*


aDepartment of Otolaryngology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, bSchool of Medicine, Tzu Chi University, Hualien, Taiwan


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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation



Objective: Frey syndrome is a complication followed by parotidectomy which caused gustatory sweating and facial flush. There were several methods for the prevention of Frey syndrome, but most of them had no obvious effects. In this study, we compare the intra‑auricular modification of facelift incision with the traditional lazy‑S incision to see if it can decrease the risk of Frey syndrome. Materials and Methods: This is a retrospective study. From 2003 to 2009, a total of 61 patients with benign parotid tumor who received
parotidectomy at Hualien Tzu Chi Hospital and were followed at outpatient department for at least 5 years were enrolled. Patients were divided into two groups according to the type of incisions during operation: (1) Group M: intra‑auricular modification of facelift incision or (2) Group S: traditional lazy‑S incision. All patients received the partial thickness sternocleidomastoid muscle flap. Clinical data including age, gender, pathologic result, presentation of Frey syndrome, size of tumor, length of operation, blood loss from surgery, length of placement of drain, total amount of drainage, and length of stay were collected and analyzed. Results: Sixty‑one patients were enrolled. Eighteen patients were in Group M and forty‑three were in Group S. There was no significant difference of age, gender, and size of tumor between the two groups. The pathologic results included parotitis, pleomorphic adenoma, Warthin’s tumor, and others. No significant difference of pathologic results, blood loss from surgery, length of placement of drain, total amount of drainage, and length of stay between two groups was obtained. The length of operation was longer in Group M (P = 0.001) and the incidence of Frey syndrome was lower in Group M than Group S (P < 0.05). Conclusions: The use of intra‑auricular modification of facelift incision can decrease the incidence of Frey syndrome.
Keywords: Frey syndrome, Intra‑auricular modification of facelift incision, Lazy‑S
incision, Sternocleidomastoid muscle flap




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