Comparison of the use of allogenic acellular dermal matrix on rates of Frey syndrome post parotidectomy: A systematic review and meta-analysis

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Jul;134(1):49-56. doi: 10.1016/j.oooo.2021.12.123. Epub 2021 Dec 24.


Objective: The aim of this study was to evaluate the efficacy of acellular dermal matrix (ADM) use in reducing Frey syndrome (FS) rates in patients postparotidectomy.

Study design: We performed a systematic review and meta-analysis of existing literature comparing rates of FS with and without ADM use.

Results: Eight studies were shortlisted for qualitative study, of which 7 compared rates of FS with and without the use of ADM. A total of 211 patients underwent parotidectomy with the use of ADM. Of these, mean patient age was 44.7 (SD ± 7.2); 89 of 159 were pleomorphic adenoma (55.9%), 29 of 159 with histological diagoses stated were Warthin's tumor (18.2%), and 159 of 211 were other histologic diagnoses (25.7%). Subjective and objective incidence rates for FS were 23 of 211 (10.9%) and 7 of 211 (3.3%), respectively. Patients in whom ADM barriers were used had significantly lower rates of subjective and objective FS (relative risk = 0.22; 95% confidence interval, 0.09-0.57; P = .002; and relative risk = 0.07; 95% confidence interval, 0.07-0.33; P < .001), respectively, compared to patients with no ADM.

Conclusion: The use of ADM was associated with lower FS rates compared to no ADM and should be considered in routine use to prevent this condition.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Acellular Dermis*
  • Adenoma, Pleomorphic* / surgery
  • Humans
  • Sweating, Gustatory* / etiology
  • Sweating, Gustatory* / prevention & control