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Effect of human acellular dermal matrix (Megaderm™) on infra-auricular depressed deformities, Frey's syndrome, and first bite syndrome following parotidectomy: a multi-center prospective study

 Joo Hyun Kim  ;  Da Hee Kim  ;  Jae-Yol Lim  ;  Ho-Ryun Won  ;  Yoo Seob Shin  ;  Chul-Ho Kim  ;  Myung Jin Ban  ;  Jae Hong Park  ;  Hyung Kwon Byeon  ;  Hyun Jun Hong  ;  Eun Chang Choi  ;  Woon Yoo Koh 
 GLAND SURGERY, Vol.10(2) : 670-677, 2021-02 
Journal Title
Issue Date
Acellular dermal matrix (ADM) ; Frey’s syndrome ; first bite syndrome ; parotidectomy
Background: Parotidectomy is the primary treatment for parotid gland tumors. However, complications may include a prominent facial scar or infra-auricular depressed deformity, Frey's syndrome, first bite syndrome, or other facial pain, numbness, and paralysis. Acellular dermal matrix (ADM) has been widely used to prevent these complications in parotid surgery, but there have been no prospective, multi-center trials documenting its efficacy. This study evaluates the effectiveness of ADM implantation in preventing infra-auricular depressed deformity, Frey's syndrome and first bite syndrome after parotidectomy. Methods: We analyzed 51 cases of standard parotidectomy and 58 cases of parotidectomy with implantation of Megaderm™ ADM through prospective multicenter trial. Acute complications including infection, seroma, hematoma, skin necrosis, and acute parotid area pain were evaluated 1 week postoperatively. Clinician grading of Frey's syndrome and blinded clinician evaluation of infra-auricular depressed deformities were conducted at 3, 6, and 12 months. Patients evaluated subjective satisfaction with neck appearance, Frey's syndrome quality, and acute parotid area pain at 3, 6, and 12 months. Results: There was a higher incidence of seroma in the Megaderm™ group than in the control group at week 1. The incidence and total clinician-evaluated Frey's syndrome scores were significantly lower in the Megaderm™ group than in the control group at 3, 6, and 12 months. Both the objective and subjective evaluations of the facial contour showed a better outcome in the Megaderm™ group compared to the control group at 3, 6, and 12 months. There were no significant differences between the groups in the patient-reported Frey's syndrome quality scores at 3, 6, and 12 months, but the Megaderm™ group reported significantly less acute pain than the control group. Conclusions: ADM implantation can effectively reduce the occurrence of Frey's syndrome, infra-auricular depressed deformity, and first bite syndrome after parotidectomy. ADM may be especially advantageous in complex parotidectomy cases when significant complications are expected.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Yoon Woo(고윤우)
Kim, Da Hee(김다희) ORCID logo https://orcid.org/0000-0001-7286-1334
Kim, Joo Hyun(김주현) ORCID logo https://orcid.org/0000-0002-8533-9649
Lim, Jae Yol(임재열) ORCID logo https://orcid.org/0000-0002-9757-6414
Choi, Eun Chang(최은창)
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