Ultrasound-guided botulinum toxin injection to treat a parotid fistula following gunshot injury

Gok, Gulcan; Michl, Petr; Williams, M. D.; Howlett, David

doi:10.1136/jramc-2013-000188

Cited by 6 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[5] Sialography can also be used to detect damage to the Stenson's duct. In a study by Gok et al, [6] it was reported that intraparenchymal Botulinum Toxin A injection was effective and more comfortable for the patient with salivary fistula. In cases where the facial nerve is damaged, early exploration and end-to-end anastomosis should be performed immediately after the patient has stabilized.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Trauma to the Parotid Gland

2018

View full text Add to dashboard Cite

P enetrating trauma to the parotid region is a rare condition and usually occurs after a gunshot injury, but can also be seen as a result of occupational accidents. Parotid tissue together with surrounding tissues, parotid duct, facial nerve, mandibular bone, and other adjacent structures may be damaged depending on the severity of penetrating trauma. Early diagnosis and intervention are important in minimizing complications. In this study, the diagnosis and treatment options are discussed in two different cases with penetrating trauma to the parotid region treated in our clinic. Case ReportCase 1 -A 20-year-old male patient with a history of gunshot injury to his face happened a week ago was admitted to our clinic in March 2017 with the complaint of restricted mouth opening. On examination, vital signs were stable, left maxillary, the infraorbital lesion on the maxillary bone, consistent with the bullet entry hole, and a skin burn Penetrating trauma to the parotid gland is a rare condition. Mostly, gunshot wounds to the parotid area are seen. Facial paralysis and sialocele formation are particular concerns and may cause significant morbidities. Early diagnosis and early exploration are crucial in the setting of facial paralysis following penetrating trauma. Sialocele formation and fistulas can be managed conservatively or surgically.

show abstract

Section: Discussionmentioning

confidence: 99%

Penetrating Trauma to the Parotid Gland

2018

View full text Add to dashboard Cite

show abstract

Botulinum toxin A is an effective therapeutic tool for the management of parotid sialocele and fistula: A systematic review

Maharaj

Mungul

Laher

2020

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objectives In the management of parotid sialocele and fistula, various conservative and surgical methods have been described. Some studies have described the use of Botulinum toxin A (Botox A) for the management of parotid sialocele and fistula. This is a less invasive and potentially equally effective option. We therefore conducted a systematic review on the current body of literature relating to this specific use of Botox A. Methods A search strategy was conducted in July 2019 using the following electronic databases: Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science. A search of all articles from inception until 31 August 2019 was performed. Results Literature searches of electronic databases identified 67 articles eligible for review, of which 15 fulfilled all criteria. These studies were small and in total only 47 patients were included. The majority of sialoceles and fistulas presented as a complication of surgery (77%) with the remaining cases occurring as a result of trauma. The typical age at presentation was between 32 and 88 years of age (mean age of 52 years). All patients were initially treated with and failed other conservative measures. Botox A injection was considered as a final conservative treatment option. The toxin was administered percutaneously in all cases of parotid sialocele and fistula. Dosage of Botox ranged from 10 to 200 units with majority of patients (58%) requiring only one injection. The overall success rate for patients treated with Botox A injections ranged between 70 and 100% for parotid sialoceles and fistulas. Conclusion Botox A injections are successful in the treatment of parotid sialoceles and fistulas and should be considered before the use of invasive conventional options. Further studies with larger numbers are needed to ratify this recommendation. Success rate for patients, treated with Botox A injection was between 70 and 100% for parotid sialocele and fistula. Patients who failed initial treatment with Botox A were re‐administered with Botox A and eventually resolved.

show abstract