Skin flap elevation including the parotid gland fascia for the prevention of frey's syndrome

To reduce the incidence of Frey's syndrome after parotidectomy, the insertion of a sternocleidomastoideus flap in the parotid area has been performed intraoperatively, but the complete prevention of Frey's syndrome is impossible. In this report, we introduce a new parotid gland surgery for the prevention of Frey's syndrome. At raising of the skin flap, we don't separate the superficial parotid fascia from the subcutaneous tissue. Therefore, the sympathetic nerves controlling the sweat glands will be preserved. Accordingly, the misdirection of nerves never arises postoperatively. In 2008, 27 patients with a fresh parotid gland tumor received an operation in the Osaka Red Cross Hospital. The subjects were 23 out of the 27 patients who received an operation with skin flap elevation including the parotid fascia for the prevention of Frey's syndrome, and who could be followed up for over six months after surgery. Histpathological classification comprised 12 cases with Warthin's tumor, 10 cases with pleomorphic adenoma and one case with a cyst. There was no incidence of Frey's syndrome in all patients.