Fat transfer; Aesthetic and functional outcomes after parotidectomy

The aim of the study is the statistical survey of influence and differences in facial defect reconstruction as well as Frey syndrome prevention between patients who undergone reconstruction with fat graft via en bloc, lipofilling techniques and control group in whom reconstruction was not carried out. 77 patients aged between 18-65 who were diagnosed with benign tumors by the aid of FNAC/MRG were included and divided into three groups: 30 patients who underwent parotidectomy surgery only called Group 1; 26 patients who underwent en bloc fat transfer after parotidectomy called Group 2; 21 patients who underwent fat transfer with lipofilling after parotidectomy called Group 3. Postoperative Frey Symptoms have interrogated, Minor Test has done, aesthetical VAS score and complications has documented in all patients. Volume of the extracted tumour and transferred fat graft as well as volumetric evaluation and resorption rates of aforementioned grafts were evaluated by the aid of MRI which was carried on at first week and first year of postoperative follow-up, Wong-Baker pain scoring was carried out at postoperative 24. hour in patients of Group 2 and 3. There was no statistical significance in resected mean of tumor volume (18±10,8 cm3) between three groups (p:0,754). However the volume of transfered fat revealed significant difference between Group 2 and 3 (23±7,59 cm3; 15±7,34 cm3) respectively. There was statistical significance that intraoperative transfered fat graft volume mean of Group 2 (23±7,59 cm3 ) was higher than Group 3 volume mean (15±7,34 cm3) (p:0,010). According to this data; %13,7 overcorrection with fat graft has done in patients of Group 2 and %24,5 less fat graft has transfered in comparison with resected tumor volume in patients of Group 3. Mean fat graft resorption rates in groups 2 and 3 were calculated to be %50,75±21.20 and %48.59±17.93 respectively and no significant difference was detected (p:0.771). Loss of time while harvesting the fat graft was also higher than in patients of Group 2 in comparison with patients of Group 3 (p:0,046). There was statistical significance that mean blood loss from donor site in patients of Group 2 was higher than in patients of Group 3 (p<0,01). According to Wong-Baker score, number of patients with donor site pain complaints were significantly higher in group 2 in comparison to group 3 (p:0.030). Visual Analogue Scale scores of group 2 and 3 patients were significantly higher than of patients in group 1 (p< 0.001). Any significant difference between group 2 and 3 was not detected (p>0.05). There wasn't any Frey Syndrome symptom and Minor Test positivity in patients of Group 2 and 3; in contrast to the patients of Group 1 (p: 0,019). Key words: Parotidectomy, fat graft, Frey Syndrome, cosmesis, reconstruction