Peroral drainage of post-traumatic sialocoeles: report of three cases

Abstract

Correct initial management of a parotid duct injury may prevent the formation of a sialocoele. When conservative treatment of post-traumatic parotid sialocoele fails, we advocate the surgical technique described in this report as it is effective, simple and carries minimal risk to the patient.

The use of botulinum toxin B in the treatment of a post-traumatic sialocele in a 4-year-old child: A case report

“…More recently, however, Witt demonstrated that post-parotidectomy sialoceles are likely to resolve spontaneously within one month without any intervention or dietary restrictions, likely due to scar formation that prevents further extravasation of saliva from the transected edges of the gland parenchyma 9 . In the event that conservative management fails or is deemed unacceptable by the patient, the most common interventions are aimed at diverting saliva through a controlled internal fistula, or depressing salivation to allow for natural healing 19,20 . Pressure dressings and antisialogogues are often used, though their utility has not been proven.…”

A Novel Approach in the Treatment of a Posttraumatic Sialocele

“…3 Not surprisingly, most techniques used to treat late complications of parotid gland injuries such as sialoceles seek to depress salivary secretions rather than reestablish glandular function. 4,5 With time, parotid secretions will stop, as eventual gland atrophy takes place.…”

“…Similarly, it has been shown that cicatrization from chronic parotid injuries leads to progressive parotid gland atrophy and poor glandular function 3 . Not surprisingly, most techniques used to treat late complications of parotid gland injuries such as sialoceles seek to depress salivary secretions rather than reestablish glandular function 4,5 . With time, parotid secretions will stop, as eventual gland atrophy takes place.…”

Penetrating Trauma to the Parotid Gland

“…10,24 In addition, an intraoral drainage is recommended, such as in sialoceles. 10,25 To improve management, a special classification system for ballistic injuries to the parotid gland has been proposed by Majid, 3 which is not based on the site of injury like the system by Van Sickels and Alexander 18 but on the patterns of injury.…”

“…Similar to other authors we recommend wound irrigation with isotonic saline solution and/or local antiseptics. 25,30 As an ideal antiseptic for irrigation of ballistic wounds especially if there is already a contamination with pus, we recommend polyhexanide solution. Further povidone iodine has proved to be particularly effective.…”