Superficial musculoaponeurotic system flap in partial parotidectomy and clinical and subclinical Frey's syndrome. Cosmesis and quality of life.

Background: Frey's syndrome (FS), facial depression, and noticeable scar may have an impact on patient's quality of life after a parotidectomy. The superficial musculoaponeurotic system (SMAS) flap has been used to ameliorate those effects.

Methods: Forty-seven consecutive parotidectomies were analyzed; SMAS flap was performed in 26 of them. We investigated clinical FS, subclinical FS, and cosmetic satisfaction, and compared SMAS flap versus cases where this was not done.

Results: By performing the SMAS flap, the occurrence of clinical FS was reduced; however, there was no significant difference. Nonetheless, there was a significant difference in the perspiration intensity in favor of the group with SMAS flaps. In the cases we studied, the cosmetic satisfaction was high, even though facial contour-filling techniques were not used.

Conclusions: Provided that the intensity of sweating is the main factor affecting the quality of life after surgery in patients, performing a SMAS flap renders the intervention worthwhile.