11/45. Congenital extraoral fistula from an auxiliary parotid gland. A rare case of an auxiliary major salivary gland in the parotid region with an external fistula is reported. Clinical findings and management are described, and relevant embryology and etiology are discussed. ( info) |
12/45. Salivary otorrhoea: a case report and a review of the literature. This report presents an unusual case of spontaneous salivary otorrhoea in which advanced imaging was used to identify a developmental defect in the anterior wall of the bony external auditory meatus. This defect, the so-called foramen of Huschke, was subsequently found to be the source of the fistula. A review of the literature highlights the diagnostic dilemmas that such cases pose for the clinician. ( info) |
13/45. The role of botulinum toxin in postparotidectomy fistula treatment. A technical note. PURPOSE: Parotid fistula is a well-known complication of parotidectomy or penetrating injury of the parotid gland. The management of parotid fistula has been controversial, and numerous conservative and surgical treatment methods have been described. methods: We report 3 cases of parotid fistula after partial parotidectomy, which were treated by botulinum toxin injection under electromyographic control into the residual substance of parotid gland. RESULTS: Complete healing of the fistula was achieved with a single botulinum toxin treatment in all patients. No side effects were observed after the treatment. The patients are disease-free after 21, 18, and 14 months, respectively. CONCLUSIONS: In the considered cases, the localized injection of botulinum toxin into the parotid gland resulted to an effective and long-lasting treatment of postparotidectomy fistula. ( info) |
14/45. Treatment of postparotidectomy fistulae with fibrin glue. Although fistulae resulting from superficial parotidectomy represent a serious problem, there is still little consensus on the optimal treatment. Some suggest management by applying dressings, while others advise surgery. In recent years several other strategies have been proposed. In this manuscript, we present two cases of postparotidectomy fistulae treated by injection with fibrin tissue glue (Tissucol Duo 500, Baxter AG, Vienna, austria). Furthermore, a review of the literature is presented. In both patients the fistulae completely healed within months without complications. A literature search revealed that this is the first time postparotidectomy fistulae were treated this way. We conclude that postparotidectomy fistulae can be effectively treated with fibrin glue. Moreover, this treatment is simple, safe and has no side effects. ( info) |
15/45. Submandibular sialogram performed through a Wharton's duct fistula: technical adaptation of conventional technique. We report a case of submandibular duct fistula in which a sialogram was performed through the fistulous opening after attempt of sialography through the Wharton's duct had failed. To our knowledge, this technical modification in obtaining a sialogram has not been described previously in scientific literature. Blunt-tipped needles and polythene catheters are commonly used for cannulation of the submandibular duct orifice for obtaining a sialogram. However, in this case, a larger gauge metallic cannula was employed to opacify the ductal system through the fistula. ( info) |
16/45. Delayed pharyngoesophageal perforation: a complication of anterior spine surgery. Stabilization of the cervical spine is often accomplished via an anterior cervical approach. Bone grafts and/or plates and screws are used to achieve stabilization. Injuries to the pharynx and esophagus are known complications in anterior exposure of the cervical spine. These injuries are manifest in the early postoperative period. Reports of late perforations are very rare. We present four cases of delayed injury to the pharynx and esophagus that resulted in abscess or fistula. We postulate that graft displacement with resulting erosion was responsible for these serious complications. Postoperative odynophagia in patients who undergo anterior cervical fusion warrants evaluation of the bone graft location. Early surgical intervention and repair may decrease prolonged morbidity in these patients. ( info) |
17/45. Parotid duct communicating with a labial pit and ectopic salivary cyst. Labial pits are usually described as blind epidermal invaginations of lip mucosa with occasional drainage of minor salivary gland secretions. A case of an aberrant parotid duct in communication with both a unilateral, commissural labial pit and an interposed salivary cyst is presented. A 7-year-old boy who had experienced lifelong clear drainage from a congenital pit at his right oral commissure developed fever, pain, and a submucosal mass of the right cheek over a 6-week period. A preoperative sialogram through the pit demonstrated a communication between the oral commissure fistula, an intervening salivary cyst, and a proximal tract from the cyst to the parotid gland. An en bloc resection of the pit, fistula tract, and cyst was performed through a transoral approach. The dissection was medial to the buccinator muscle. There has been no recurrence of the cyst after 1 year follow-up. A description of labial pits and parotid duct anomalies is presented; however, to our knowledge, this combination of anomalies has not been previously described. ( info) |
18/45. Parotid salivary fistula following rhytidectomy. With the advent of suction-assisted lipectomy and superficial muscular aponeurotic system procedure for face-lift, the risk of parotid injury increases. A case of parotid salivary fistula is presented and its management discussed. ( info) |
| Two cases are presented that show the progression to sialocele or salivary fistula, or both, after a modified Risdon approach is used for mandibular subcondylar osteotomy. Use of antisialogogues and conservative management is recommended. ( info) |
| Large calculi of the salivary glands are rare. They may go undetected for many years. The authors report three cases of giant submandibular gland calculi. In one patient, the calculus was an incidental finding. In all patients, the mass was in the substance of the gland; in one, the configuration of the mass was unusual and it had eroded through the floor of the buccal cavity forming an orocervical fistula (the first such report) and in another the mass occupied a small portion of Wharton's duct. The histopathologic findings in all three cases were of nonspecific chronic inflammation. All the patients made a smooth recovery and had no complaints at follow-up. ( info) |