Author(s)
Barrett J Anderies BS
Jacob K Dey MD
Nelson R Gruszczynski BA
Daniel L Price MD
Eric J Moore MD
Jeffrey R Janus MD
Affiliation(s)
Mayo Clinic;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to explain the gaze patterns associated with parotidectomy facial contour defects and the impact of dermal fat graft reconstruction.
Objectives: Use validated eye tracking software to objectively measure 1) the attentional distraction of facial contour defects after superficial and total parotidectomy; and 2) changes in attentional distraction with and without abdominal dermal fat graft reconstruction.
Study Design: Randomized controlled experiment.
Methods: Standardized frontal and oblique facial images of 16 patients who had undergone superficial or total parotidectomies with or without fat grafting and 4 normal controls were obtained. 100 naïve observers were recruited to view these images and gaze data were collected using a Tobii eye tracking system. Gaze durations for predefined facial areas of interest were analyzed using mixed effects linear regression.
Results: For frontal images, having a total parotidectomy increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (p<0.001), while superficial parotidectomy did not (p=0.137). For oblique images, both superficial and total parotidectomy without fat grafting significantly increased gaze to the operated parotid area compared to the contralateral nonoperated parotid area (456 and 658 milliseconds respectively, p<0.001). This attentional distraction was also measured by comparing superficial and total parotidectomy patients to normal control faces. Dermal fat grafting normalized attentional distraction for both superficial and total parotidectomy patients, with no statistically significant difference in fixation time on the operated parotid region compared to normal control faces (p=0.189, p=0.110, respectively).
Conclusions: Eye tracking objectively demonstrates that casual observers show attentional distraction to the parotid region after superficial and total parotidectomy without fat grafting. Dermal fat grafting normalizes attention to parotid regions for both superficial and total parotidectomy.