Patient and Surgeon-Reported Satisfaction With Reconstruction Following Superficial Parotidectomy: A Systematic Review and Meta-Analysis.

Objectives: (1) Assess current methods for the collection of patient- and surgeon-reported outcomes after superficial parotidectomy reconstruction. (2) Determine which post-parotidectomy reconstructive method provides the highest degree of patient satisfaction.

Methods: PRISMA guidelines were followed for article identification and selection. A total of 17 peer-reviewed articles including 898 patients were included in the study. Outcome data was mathematically harmonized across studies to allow statistical analysis. Random effects meta-analysis of proportions was performed. The Freeman-Tukey Double Arcsine method was used to calculate the pooled estimate, or rate for each analyzed outcome.

Results: No standardized or previously validated instrument was used to collect patient satisfaction data following superficial parotidectomy reconstruction in any of the included studies. After data harmonization, overall patient satisfaction was 93% when no reconstruction was performed, compared to 97% for sternocleidomastoid flap (SCM), and 100% for superficial muscular aponeurotic system flap (SMAS). Patient satisfaction of symmetry was 41% when no reconstruction was performed, compared to 65% for SMAS, 95% for free fat graft, and 96% for SCM.

Conclusions: Reporting methods for patient satisfaction with appearance and symmetry after superficial parotidectomy and reconstruction are heterogeneous and non-standardized. Artificially harmonized data demonstrate that patient-reported outcomes of satisfaction and symmetry were improved following any form of reconstruction after parotidectomy, and patients reported symmetry-specific satisfaction was less when SMAS reconstruction was performed. Validated and objective instruments should be utilized to determine the optimal approach to facial reconstruction after superficial parotidectomy to maximize patient-centered outcomes. 3.