Fat transfer after parotidectomy: fat resorption rates, aesthetic and functional outcomes of en-bloc fat graft versus lipofilling technique

Tunca, Merve; Süslü, Nilda; Karaosmanoglu, Ayca Akgoz

doi:10.1007/s00405-020-06570-y

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…Tunca et al . 35 and Curry et al . 22 concluded that SMAS flap plication may not be enough to compensate for large parotid defects.…”

Section: Discussionmentioning

confidence: 94%

“…Many previous studies have documented that FDFG 2 , 5 , 6 , 8 , 14 , 15 , 18 , 25 , 26 , 33 , 35 , 36 , SMAS flap 3 , 4 , 8 , 11 , 20 , 22 , 32 , or using both together 21 , 22 has a statistically significant effect in lowering the incidence of Frey’s syndrome and increasing cosmetic and aesthetic satisfaction. The current study added that there was no statistically significant difference between FDFG and SMAS flap regarding these parameters.…”

Section: Discussionmentioning

confidence: 98%

“…One of the unique sequelae of FDFG is fat resorption, which may range from 10 to 50 per cent of its original volume 19 , 35 . This shrinkage was explained by Mackay et al .…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial

2023

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Background Parotidectomy is the standard procedure for treatment of many parotid lesions; however, it has several drawbacks. Facial asymmetry and Frey’s syndrome are the most annoying complications to patients. Insertion of interpositioning grafts into the parotidectomy bed can decrease these complications significantly. Free dermal fat graft (FDFG) and superficial musculoaponeurotic system (SMAS) flap have very promising results. This RCT aimed to compare these two techniques regarding functional and aesthetic outcomes. Methods Between February 2016 and October 2021, adult patients undergoing superficial conservative parotidectomy in a single centre for a benign indication were randomized into two equal groups using a closed envelope method. In one group, FDFG was inserted at the parotidectomy bed, whereas, in the other group, SMAS flap was performed. Preoperative, operative, and postoperative data were recorded and analysed. The primary outcome was the development of Frey's syndrome. Results Seventy-eight patients were randomized into two equal groups of 39 patients. There was no significant difference between the two groups regarding development of Frey's syndrome. There was no significant statistical difference between study groups regarding demographic data, co-morbidities, parotid pathologies, specimen volumes, total operating time, and postoperative complications. A tendency for over correction was observed in FDFG and under correction in SMAS flap. There was no statistically significant difference between the study groups regarding the patients’ aesthetic satisfaction with the majority displaying excellent satisfaction with no poor results. Conclusion FDFG and SMAS flap are simple, rapid, and reliable procedures and are effective in improving both functional and aesthetic outcomes post-parotidectomy. They have comparable results; however, selection of either procedure can be determined according to patient and tumour characteristics. Registration number: NCT05452837 (http://www.clinicaltrials.gov)

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“…Tunca et al . 35 and Curry et al . 22 concluded that SMAS flap plication may not be enough to compensate for large parotid defects.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

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Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial

2023

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“…Tunca et al (26) in 2021 described a 57-patient retrospective review of MRI-measured volume retention of en bloc facial fat grafts versus lipofilling. Initial en bloc fat graft size averaged 23 cm 3 versus 15 cm 3 for lipofilling, but no significant difference in retention was found between the two ( en bloc 50.8% vs. lipofilling 48.6% at 1 year).…”

Section: Discussionmentioning

confidence: 99%

Quantification of Fat Graft Retention in the Translabyrinthine Approach Using Magnetic Resonance Imaging Volumetric Analysis

et al. 2023

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Objective: To characterize the viability and volume of autologous free fat grafts over time, determine clinical/patient factors that may affect free fat graft survival and assess the clinical impact of free fat graft survival on patient outcomes in the translabyrinthine approach for lateral skull base tumor resection. Study Design: Retrospective chart review. Setting: Tertiary neurotologic referral center. Patients: Forty-two adult patients who underwent translabyrinthine craniotomy for resection of a lateral skull base tumor with the mastoid defect filled by autologous abdominal fat graft and subsequently underwent more than one postoperative magnetic resonance imaging (MRI) scans of the brain. Intervention(s): Mastoid obliteration with abdominal fat after craniotomy, postoperative MRI Main Outcome Measure(s): Rate of fat graft volume loss, fraction retention of original fat graft volume, initial fat graft volume, time to steady-state fat graft retention, rate of postoperative cerebrospinal fluid (CSF) leak, and/or pseudomeningocele formation. Results: Patients were followed postoperatively with MRI for a mean of 31.6 months with a mean of 3.2 postoperative MRIs per patient. Initial graft size was a mean of 18.7 cm 3 with a steady-state fat graft retention of 35.5%. Steady-state graft retention (<5% loss per year) was achieved at a mean of 24.96 months postoperatively. No significant association was found in multivariate regression analysis of clinical factors impact on fat graft retention and CSF leak/ pseudomeningocele formation. Conclusions: In the use of autologous abdominal free fat graft for filling mastoid defects after translabyrinthine craniotomy, there is a logarithmic decline in fat graft volume over time, reaching steady state in 2 years. Rates of CSF leak or pseudomeningocele formation were not significantly affected by initial volume of the fat graft, rate of fat graft resorption, nor the fraction of original fat graft volume at steady state. In addition, no analyzed clinical factors significantly influenced fat graft retention over time.

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“…The volume of fat transferred in the parotidectomy region has not been clearly identified. Moreover, the percentage of fat graft resorption in parotid bed reconstruction is unknown, and most studies have been based on the rates of fat graft resorption at other sites of the face or body 17 . Generally, fat resorption occurs during the first three months after lipofilling 18 .…”

Section: Discussionmentioning

confidence: 99%

Lipofilling after total parotidectomy: a useful option to prevent functional and aesthetic sequelae

Crosetti

Arrigoni²,

Fantini

et al. 2022

Acta Otorhinolaryngol Ital

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SUMMARY Objective Parotidectomy is the main treatment for parotid tumours, but its functional and aesthetic sequelae can be very disturbing for patients. Methods 15 patients underwent total conservative parotidectomy, harvesting of a superficial musculoaponeurotic system (SMAS) flap and lipofilling between May 2014 and June 2020 for a benign parotid tumour. Aesthetic, functional sequelae and cosmetic results were assessed with the House-Brackmann scale, Luna-Ortiz’s classification and a semiquantitative questionnaire. Lipofilling resorption was analysed by maxillofacial and neck MRI imaging at 2 years after surgery. The results were compared to a group of 21 patients who underwent total parotidectomy without harvesting a SMAS flap and lipofilling. Results No complications were observed. No facial defects were seen during follow-up. Post-operative MRI showed fat resorption was less than 20% in 12 patients and from 20 to 30% in 3 patients. Cosmetic satisfaction was 100% in all cases. Only 1 patient (6%) complained of Frey’s syndrome. Conclusions Lipofilling is an excellent solution considering its efficacy, safety, simplicity, duration over time and economic costs. Donor site invasiveness is minimal, and reintervention is always possible. Face-lift incision and SMAS flap can improve aesthetic results and minimise the disfiguring impact of the surgical scar.

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Fat transfer after parotidectomy: fat resorption rates, aesthetic and functional outcomes of en-bloc fat graft versus lipofilling technique

Cited by 6 publications

References 15 publications

Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial

Evaluation of functional and aesthetic outcomes of free dermal fat graft versus superficial musculoaponeurotic system flap after superficial parotidectomy: randomized clinical trial

Quantification of Fat Graft Retention in the Translabyrinthine Approach Using Magnetic Resonance Imaging Volumetric Analysis

Lipofilling after total parotidectomy: a useful option to prevent functional and aesthetic sequelae

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