Use of irradiate animal pericardium membrane for prevention of Frey’s syndrome after parotidectomy

P. Gennaro, P. Di Curzio, V. Mitro, A. Facchini, G. Saponaro, F. Cascino, G. Amodeo, G. Gabriele, C. Ungari

Maxillo-Facial Surgery Unit, Policlinico “Umberto I”, “Sapienza” University, Rome, Italy. gianmarco.saponaro@gmail.com

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• Maxillofacial Surgery

BACKGROUND: Frey syndrome is a common complication that appears few months after parotid surgery with flushing and sweating of the parotid-temporal area during mastication. It presumably originates from an aberrant nervous regeneration in which the parasympathetic fibers of the parotid gland would combine themselves with the sympathetic fibers of the sweat glands and with the cutaneous vessels.

AIM: In the present study we analyze the effectiveness of a collagenous membrane derived from animal pericardium (APM) to prevent Frey’s syndrome after parotidectomy.

MATERIALS AND METHODS: We studied a total of 40 patients with benign tumors of the parotid gland, including 30 patients with pleomorphic adenoma, 7 patients with Warthin tumor and 3 with basal cells adenoma.
The patients were divided into 2 groups: group 1 (experimental n=20) executed superficial parotidectomy with replacement of bovine pericardial matrix (BPM); group 2 (control n=20) underwent superficial parotidectomy followed by reposition of superficial musculoaponeurotic system (SMAS) flap. All patients were questioned over their subjective symptom and tested with Minor’s test after 12 months from the intervention and introduced in a follow-up of 3 years.

RESULTS: Subjectively Frey syndrome was referred in 5% of patients in group 1 and in10% in group 2, while 0 cases were observed in group 1 after the starch-iodine test, 2 cases in group 2 (10%).

CONCLUSIONS: Considering the present results, although this study needs further implementation, we can affirm that BPM is a valid option in preventing Frey’s syndrome whereas SMAS flap is not available.

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