Case Report
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J Cosmet Med 2022; 6(1): 56-60
Published online June 30, 2022
Combined sternocleidomastoid and superficial muscular aponeurotic system flap reconstruction after malignant parotid tumor excision: a case report
Ibrahim AlQuniabut, MD1 
, Ji Yun Choi, MD, PhD2 , Jeonghyun Oh, MD, PhD2
1Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
2Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea
Correspondence to :
Jeonghyun Oh
E-mail: way2ojay@naver.com
© Korean Society of Korean Cosmetic Surgery & Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The parotid gland, which is the largest salivary gland, is the most common gland harboring tumors. Parotidectomy frequently alters facial appearance, particularly in terms of leading to deformities and scars. A 38-year-old male with a large malignant right parotid tumor underwent resection of the tumor leading to a significant soft tissue depression and defect over the parotid region. We successfully reconstructed the defect using a combined superficial musculoaponeurotic system flap and a superiorly based partial thickness myocutaneous sternocleidomastoid muscle flap reinforced with the platysma. Postoperatively, the patient received radiotherapy and exhibited good esthetics and facial harmony.
Keywords: facial contour deformity, parotid, parotid tumor, parotidectomy, sternocleidomastoid muscle flap, superficial musculoaponeurotic system flap
Fig. 1.(A) Preoperative view of the protruding right parotid mass, which led to facial disfigurement. (B) Preoperative status of the mass occupying the parotid region.
- Anderies BJ, Dey JK, Gruszczynski NR, Price DL, Moore EJ, Janus JR. Dermal fat grafting to reconstruct the paroti-dectomy defect normalizes facial attention. Laryngoscope 2021;131:E124-31.
- Kim IK, Cho HW, Cho HY, Seo JH, Lee DH, Park SH. Facelift incision and superficial musculoaponeurotic system ad-vancement in parotidectomy: case reports. Maxillofac Plast Reconstr Surg 2015;37:40.
- Nellis JC, Ishii M, Byrne PJ, Boahene KDO, Dey JK, Ishii LE. Association among facial paralysis, depression, and quality of life in facial plastic surgery patients. JAMA Facial Plast Surg 2017;19:190-6.
- Jain A, Rai A. Meta-analysis to evaluate the efficacy of ster-nocleidomastoid muscle flap as a reconstruction modality in prevention of Frey’s syndrome following parotidectomy. J Maxillofac Oral Surg 2021;20:310-8.
- Giotakis EI, Giotakis AI. Modified facelift incision and super-ficial musculoaponeurotic system flap in parotid malignancy: a retrospective study and review of the literature. World J Surg Oncol 2020;18:8.
- Pham M, Eviston TJ, Clark JR. Reconstruction of limited parotidectomy defects using the dermofat graft. ANZ J Surg 2017;87:E256-60.
- Mehta R, Punjabi M, Soni R, Dagur M, Patidar P, Singh P. Ster-nocleidomastoid flap in parotid surgery: a case series. Indian J Otolaryngol Head Neck Surg 2018;70:434-7.
- Cai YC, Shui CY, Li C, Sun RH, Zhou YQ, Liu W, et al. Primary repair and reconstruction of tumor defects in parotid masse-ter region: a report of 58 cases. Gland Surg 2019;8:354-61.
- Manola M, Moscillo L, Simeon V, De Luca E, Mastella A. The effectiveness of sternocleidomastoid flap versus superficial musculoaponeurotic system flap for the prevention of Frey syndrome and facial depressed deformity in parotid surgery for pleomorphic adenoma. Ann Plast Surg 2018;80:125-9.
- Dell’Aversana Orabona G, Salzano G, Abbate V, Piombino P, Astarita F, Iaconetta G, et al. Use of the SMAS flap for re-construction of the parotid lodge. Acta Otorhinolaryngol Ital 2015;35:406-11.
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Case Report
J Cosmet Med 2022; 6(1): 56-60
Published online June 30, 2022 https://doi.org/10.25056/JCM.2022.6.1.56
Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.
Combined sternocleidomastoid and superficial muscular aponeurotic system flap reconstruction after malignant parotid tumor excision: a case report
Ibrahim AlQuniabut, MD1 , Ji Yun Choi, MD, PhD2 , Jeonghyun Oh, MD, PhD2
1Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
2Department of Otolaryngology-Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Rep. of Korea
Correspondence to:Jeonghyun Oh
E-mail: way2ojay@naver.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The parotid gland, which is the largest salivary gland, is the most common gland harboring tumors. Parotidectomy frequently alters facial appearance, particularly in terms of leading to deformities and scars. A 38-year-old male with a large malignant right parotid tumor underwent resection of the tumor leading to a significant soft tissue depression and defect over the parotid region. We successfully reconstructed the defect using a combined superficial musculoaponeurotic system flap and a superiorly based partial thickness myocutaneous sternocleidomastoid muscle flap reinforced with the platysma. Postoperatively, the patient received radiotherapy and exhibited good esthetics and facial harmony.
Keywords: facial contour deformity, parotid, parotid tumor, parotidectomy, sternocleidomastoid muscle flap, superficial musculoaponeurotic system flap
Fig 1.
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References
- Anderies BJ, Dey JK, Gruszczynski NR, Price DL, Moore EJ, Janus JR. Dermal fat grafting to reconstruct the paroti-dectomy defect normalizes facial attention. Laryngoscope 2021;131:E124-31.
- Kim IK, Cho HW, Cho HY, Seo JH, Lee DH, Park SH. Facelift incision and superficial musculoaponeurotic system ad-vancement in parotidectomy: case reports. Maxillofac Plast Reconstr Surg 2015;37:40.
- Nellis JC, Ishii M, Byrne PJ, Boahene KDO, Dey JK, Ishii LE. Association among facial paralysis, depression, and quality of life in facial plastic surgery patients. JAMA Facial Plast Surg 2017;19:190-6.
- Jain A, Rai A. Meta-analysis to evaluate the efficacy of ster-nocleidomastoid muscle flap as a reconstruction modality in prevention of Frey’s syndrome following parotidectomy. J Maxillofac Oral Surg 2021;20:310-8.
- Giotakis EI, Giotakis AI. Modified facelift incision and super-ficial musculoaponeurotic system flap in parotid malignancy: a retrospective study and review of the literature. World J Surg Oncol 2020;18:8.
- Pham M, Eviston TJ, Clark JR. Reconstruction of limited parotidectomy defects using the dermofat graft. ANZ J Surg 2017;87:E256-60.
- Mehta R, Punjabi M, Soni R, Dagur M, Patidar P, Singh P. Ster-nocleidomastoid flap in parotid surgery: a case series. Indian J Otolaryngol Head Neck Surg 2018;70:434-7.
- Cai YC, Shui CY, Li C, Sun RH, Zhou YQ, Liu W, et al. Primary repair and reconstruction of tumor defects in parotid masse-ter region: a report of 58 cases. Gland Surg 2019;8:354-61.
- Manola M, Moscillo L, Simeon V, De Luca E, Mastella A. The effectiveness of sternocleidomastoid flap versus superficial musculoaponeurotic system flap for the prevention of Frey syndrome and facial depressed deformity in parotid surgery for pleomorphic adenoma. Ann Plast Surg 2018;80:125-9.
- Dell’Aversana Orabona G, Salzano G, Abbate V, Piombino P, Astarita F, Iaconetta G, et al. Use of the SMAS flap for re-construction of the parotid lodge. Acta Otorhinolaryngol Ital 2015;35:406-11.
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