Meta-Analysis to Evaluate the Efficacy of Sternocleidomastoid Muscle Flap as a Reconstruction Modality in Prevention of Frey's Syndrome Following Parotidectomy

J Maxillofac Oral Surg. 2021 Jun;20(2):310-318. doi: 10.1007/s12663-020-01380-5. Epub 2020 May 6.

Abstract

Background: One of the commonest complications following parotidectomy is Frey's syndrome (FS). The use of sternocleidomastoid muscle (SCM) flap to prevent FS is controversial. Hence, this study has been designed to compare the effect of SCM flap with no reconstruction in prevention of FS following parotidectomy.

Methodology: An exhaustive literature search was conducted in July 2019. Studies focusing on sternocleidomastoid flap following parotidectomy were included in the meta-analysis. A random effects model was used to generate pooled estimates. Odds ratio with a 95% confidence interval was calculated for subjective symptoms and objective test.

Results: A total of 125 studies were identified, out of which 17 studies were recruited in the meta-analysis. Sixteen studies were analyzed for the subjective symptoms, and ten were analyzed for the objective signs. There was no statistically significant difference in the occurrence of FS with the use of SCM flap on objective analysis. However, the subjective analysis showed a statistically significant reduction in FS following reconstruction with SCM flap after parotidectomy.

Conclusion: The present meta-analysis suggests that the use of SCM flap following parotidectomy has no effect in reducing the incidence of Frey's syndrome.

Keywords: Frey’s syndrome; Parotidectomy; Sternocleidomastoid muscle flap.