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Cochran J, Gottfried J, Chernichenko N, Walvekar RR, Butts SC. Traumatic Injuries of the Parotid Gland and Duct. Otolaryngol Clin North Am 2023; 56:1027-1038. [PMID: 37369609 DOI: 10.1016/j.otc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
This review will focus on the key steps in the recognition of parotid gland and duct injuries focusing on the important steps needed at the initial assessment. Management planning is presented in the way that trauma surgeons interact with patients, highlighting the important parts of the informed consent conversation followed by the key information that must be communicated to the anesthesia and operating room teams, which ensures proper monitoring and equipment needs are in place. Short-term and long-term outcomes for patients with persistent sequelae of the trauma and their management are reviewed.
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Affiliation(s)
- James Cochran
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA
| | - Jennifer Gottfried
- SUNY Downstate Health Sciences University-College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Natalya Chernichenko
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Rohan R Walvekar
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, 533 Bolivar Street, Suite 566, New Orleans, LA 70112, USA
| | - Sydney C Butts
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA.
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2
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Hwang M, Engelstad M, Chandra SR. Management of Soft Tissue Injuries in Children-A Comprehensive Review. Oral Maxillofac Surg Clin North Am 2023; 35:619-629. [PMID: 37567828 DOI: 10.1016/j.coms.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Airway injury, Ocular injury and neurovascular tissue damage, burns is all a spectrum of pediatric soft tissue injury complex. Soft tissue injuries to the head and neck area in children are challenging to manage, because these injuries significantly affect the child's overall health and development. Management of such injuries requires a multidisciplinary approach involving surgical and nonsurgical interventions and close collaboration among health care professionals, parents, and caregivers. This article reviews the various causes of injuries, specific considerations for each region of the head and neck, and approaches to the surgical management of soft tissue injuries in pediatric patients, including surgical and adjuvant therapies. Specific anatomic regions reviewed include the scalp/forehead, periorbital region, nose, cheeks, lips, ears, and neck/airway.Laceration repair in the growing pediatric populations may require revisions in the future. Facial soft tissue injuries are prone to poor cosmesis as in many occasions as may be constrained by available surgical specialists, thus proper multispecialty team approach along with surgical alignment and symmetry should be considered comprehensively.
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Affiliation(s)
- Marcus Hwang
- Department of Oral Maxillofacial Surgery, Oregon Health and Sciences, Portland, OR, USA
| | - Mark Engelstad
- Department of Oral Maxillofacial Surgery, Oregon Health and Sciences, Portland, OR, USA
| | - Srinivasa Rama Chandra
- Department of Oral Maxillofacial Surgery, Oregon Health and Sciences, Portland, OR, USA.
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3
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Belcastro A, Reed W, Puscas L. The Management of Salivary Fistulas. Semin Plast Surg 2023; 37:4-8. [PMID: 36776805 PMCID: PMC9911217 DOI: 10.1055/s-0042-1759561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Postoperative salivary fistula is an especially undesirable complication because it can be difficult to address, may delay postoperative radiation, and always delays enteral nutrition. Patients who are malnourished, have already undergone radiotherapy, or are hypothyroid are at higher risk of developing this problem. Conservative measures work in most patients, but a significant percentage of patients require intervention beyond pressure dressings and tincture of time. Medications, hyperbaric oxygen therapy, and surgical intervention may be required when fistulas do not heal in a timely manner. Decisions about the approach and timing of more aggressive interventions are part of the art of medicine since definitive scientific protocols are lacking.
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Affiliation(s)
- Alexandra Belcastro
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - William Reed
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Liana Puscas
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
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Vielsmeier V, Hackenberg S, Schelzig H, Knapsis A. [Update on neck trauma]. HNO 2022; 70:724-735. [PMID: 36066623 DOI: 10.1007/s00106-022-01214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Important organs and structures are located in the cervical region. In case of blunt and penetrating trauma, emergency situations may arise. OBJECTIVE Emergency management as well as diagnostic and therapeutic steps pertaining to neck injuries are presented. CONCLUSION Shock therapy and airway management are essential, fast management of neck injuries highly relevant.
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Affiliation(s)
- V Vielsmeier
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Regensburg, Deutschland.
| | - S Hackenberg
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - H Schelzig
- Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - A Knapsis
- Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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5
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Delayed Management of Parotid Sialocele: Role for Two-week Intraoral Drainage. Curr Med Sci 2022; 42:902-904. [DOI: 10.1007/s11596-022-2619-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 02/07/2020] [Indexed: 11/25/2022]
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6
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Cho DY, Willborg BE, Lu GN. Management of Traumatic Soft Tissue Injuries of the Face. Semin Plast Surg 2021; 35:229-237. [PMID: 34819804 DOI: 10.1055/s-0041-1735814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Facial soft tissue injuries encompass a broad spectrum of presentations and often present significant challenges to the craniofacial surgeon. A thorough and systematic approach to these patients is critical to ensure that the patient is stabilized, other injuries identified, and the full extent of the injuries are assessed. Initial management focuses on wound cleaning with irrigation, hemostasis, and debridement of nonviable tissue. Definitive management is dependent on the region of the face involved with special considerations for critical structures such as the globe, lacrimal apparatus, facial nerve, and parotid duct. Following sound surgical principles, these injuries can be managed to maximize both functional and aesthetic outcomes while minimizing complications.
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Affiliation(s)
- Daniel Y Cho
- Division of Plastic Surgery, Harborview Medical Center, University of Washington, Seattle, Washington
| | - Brooke E Willborg
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - G Nina Lu
- Department of Otolaryngology-Head and Neck Surgery, Harborview Medical Center, University of Washington, Seattle, Washington
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7
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Eng J, Sivam S. General Overview of the Facial Trauma Evaluation. Facial Plast Surg Clin North Am 2021; 30:1-9. [PMID: 34809879 DOI: 10.1016/j.fsc.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The initial evaluation of maxillofacial trauma in athletes should first focus on the management of life-threatening injuries that require emergent care. Airway, breathing, and circulation are the 3 areas to be addressed first and foremost, as set forth by Advanced Trauma Life Support (ATLS) guidelines. Following the stabilization of the patient, a thorough physical examination and systematic review of any relevant imaging studies are imperative to ensure that injuries are not missed. Ultimately, management by the facial plastic surgeon should balance the goals of facial trauma restoration with the overall needs of the patient.
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Affiliation(s)
- James Eng
- Divison of Facial Plastic & Reconstructive Surgery, Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, 1977 Butler Boulevard, Suite E5.200, Houston, TX 77030, USA
| | - Sunthosh Sivam
- Divison of Facial Plastic & Reconstructive Surgery, Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, 1977 Butler Boulevard, Suite E5.200, Houston, TX 77030, USA.
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8
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Uzmansel D, Elvan Ö, Aktekin M. Precise localization of parotid duct: a cadaveric study. Anat Sci Int 2021; 97:59-64. [PMID: 34392495 DOI: 10.1007/s12565-021-00626-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/06/2021] [Indexed: 12/01/2022]
Abstract
This study aimed to determine the precise localization and course of parotid duct based on morphometric data obtained by measurements regarding several superficial landmarks and lines. Totally, 46 parotid ducts of 24 formalin-fixed adult amputated heads (12 female and 12 male) aged between 45 and 92 years, present in the collection of Anatomy Department, School of Medicine, Mersin University, were evaluated. First, three reference lines were defined: L1: between intertragic notch and labial commissure, L2: between intertragic notch and nasal wing, and L3: between intertragic notch and lateral palpebral commissure. The location of the parotid duct with respect to these lines were recorded. In all sides, parotid duct was detected in the middle 1/3 of L1. In 71.7% of all hemifaces, the parotid duct was making an upward curve around L1. Its proximal end exiting from the anterior border of the parotid gland was 12.34 ± 28.83 mm below the proximal 1/3 point of L1. Then, it was crossing L1 at a point with a mean distance of 53.90 ± 9.69 mm from the labial commissure where it is almost at L1 midpoint. Its distal end was located 9.61 ± 2.88 mm above the distal 1/3 point of L1. In 21.7% of all hemifaces, PD was observed totally above L1, while the shortest distances of its proximal and distal ends to L1 were 4.35 ± 2.45 mm and 13.17 ± 4.52 mm, respectively. In 6.5% of all hemifaces, its proximal end was located just on L1, coursing upwards and terminating 11.76 ± 2.53 mm above L1.
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Affiliation(s)
- Deniz Uzmansel
- Department of Anatomy, School of Medicine, Mersin University, Çiftlikköy Campus, Yenişehir, 33343, Mersin, Turkey
| | - Özlem Elvan
- School of Health, Mersin University, Mersin, Turkey.
| | - Mustafa Aktekin
- Department of Anatomy, School of Medicine, Acıbadem University, Istanbul, Turkey
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Abstract
Although a rare sequala of soft tissue injury, salivary gland trauma may result in significant morbidity. Salivary gland injury can involve the major as well as the minor glands. Because of the proximity of adjacent vital structures, a thorough history and physical examination are mandatory during patient evaluation. Trauma to the major salivary glands may involve the parenchyma, duct, or neural injury. Treatment requires adherence to primary principles of soft tissue management. Ductal and neural injury should be repaired primarily. Sialocele and fistula are potential complications of repaired and unrepaired salivary gland injury.
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Affiliation(s)
- Raymond P Shupak
- Division of Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, 1500 South Main Street, Fort Worth, TX 76104, USA.
| | - Fayette C Williams
- Division of Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, 1500 South Main Street, Fort Worth, TX 76104, USA
| | - Roderick Y Kim
- Division of Maxillofacial Oncology and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, 1500 South Main Street, Fort Worth, TX 76104, USA
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10
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Abstract
Duct scar in the form of stenoses or stricture is the second leading cause of obstructive sialadenitis after stone. Over the past decade, there has been a growing experience demonstrating the effectiveness of endoscopic techniques in the minimally invasive management of salivary duct stenosis. Less information, however, is available with regard to open approaches for recurrent or complex ductal stenoses. This article reports on a case of gland preservation using an open ductal technique that originally was applied in cases of traumatic Stensen's duct injury.
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Affiliation(s)
- Leighton F Reed
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA
| | - M Boyd Gillespie
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 408, Memphis, TN 38163, USA
| | - Trevor Hackman
- Department of Otolaryngology-Head and Neck Surgery, UNC Hospitals, 170 Manning Drive, Chapel Hill, NC 27599-7070, USA.
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11
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Abstract
Mucoceles are common salivary gland disorders. Mucoceles are benign, mucus-filled extravasation pseudocysts that commonly arise on the lower lip of children and young adults. Although surgical excision is commonly performed to remove these lesions, other treatments include marsupialization, micromarsupialization laser ablation, cryotherapy, intralesional steroid injection, and sclerosing agents. Traumatic sialoceles commonly arise from injury to the parotid duct. Treatment of sialoceles from acute parotid duct injury and for delayed presentations after injury are discussed. Ranulas are a subtype of mucocele from the sublingual gland classified as superficial or plunging. Treatment of ranulas must address the sublingual gland.
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Affiliation(s)
- Eve M R Bowers
- Department of Otolaryngology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, 3350 Terrace Street, Pittsburgh, PA 15213, USA
| | - Barry Schaitkin
- Department of Otolaryngology, University of Pittsburgh Medical Center, Shadyside Hospital, Suite 211, 5200 Centre Avenue, Pittsburgh, PA 15232, USA.
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12
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McElwee TJ, Poche JN, Sowder JC, Hetzler LT. Management of Acute Facial Nerve and Parotid Injuries. Facial Plast Surg 2021; 37:490-499. [PMID: 33648012 DOI: 10.1055/s-0041-1725129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Acute soft tissue trauma to the head and neck is a common reason for emergency department presentation and should be appropriately evaluated by a facial plastic surgeon. The evaluation of a patient who has suffered facial trauma should always include a comprehensive facial nerve exam and carry a low threshold of suspicion for parotid duct injury when involving the cheek. Injuries to the facial nerve and parotid duct can result in significant long-term functional, cosmetic, and emotional morbidity, particularly when diagnosis is delayed. In the repair of facial nerve transection, neurorrhaphy technique is primarily based on the ability to obtain tension-free anastomosis and outcomes are in large part related to timing of repair. Parotid duct injuries are generally repaired based on the site of ductal injury. In this article, we present a guide to the relevant anatomy of the facial nerve branches and the parotid duct, the important factors guiding treatment decisions alongside their related risks and benefits, as well as the management of complications of facial nerve neurorrhaphy and parotid duct injuries and repair.
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Affiliation(s)
- Tyler J McElwee
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana
| | - John N Poche
- College of Medicine, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana
| | - Justin C Sowder
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center New Orleans, Baton Rouge, Louisiana.,Department of Otolaryngology Head and Neck Surgery, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana
| | - Laura T Hetzler
- Department of Otolaryngology Head and Neck Surgery, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana.,Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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13
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Mardani M, Arabion H. Surgical Management of Parotid Duct Injury Using a Feeding Tube. Ann Maxillofac Surg 2020; 10:472-474. [PMID: 33708598 PMCID: PMC7943975 DOI: 10.4103/ams.ams_238_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/28/2020] [Accepted: 04/18/2020] [Indexed: 11/04/2022] Open
Abstract
The parotid duct (Stenson's duct) can be damaged during traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great importance because complications such as sialocele and salivary gland fistula may develop if the duct is not surgically repaired. We think that the feeding tube is an ideal material in the parotid duct repair because of its technical characteristics, availability, and low cost. In this article, we described the use of a feeding tube for the treatment of a parotid duct rupture in a facial stab wound laceration, as it is a low-cost and easy-to-access material readily available in every operating room.
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Affiliation(s)
- Mohsen Mardani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Arabion
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Fukumasa H, Tsuda M, Ninomiya R, Kobayashi M, Nishiyama K, Ito A, Tasaki Y, Amamoto M. Parotid gland atrophy after conservative treatment of a post-traumatic parotid fistula in a two-year-old boy. Int J Pediatr Otorhinolaryngol 2020; 138:110326. [PMID: 32861193 DOI: 10.1016/j.ijporl.2020.110326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
A parotid fistula is a rare complication following parotid gland and duct injury. A two-year-old boy with a previous parotid fistula after parotid injury due to a dog bite was successfully treated with pressure-dressing therapy, which is generally non-invasive and tolerable by young children. During follow-up, ultrasonography revealed atrophy of the parotid gland. This finding is consistent with the healing mechanism previously assumed in adult patients with a parotid fistula. Consideration should be paid to the possibility of oral environmental changes associated with reduced saliva secretion from parotid gland atrophy after conservative treatment of parotid fistula.
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Affiliation(s)
- Hiroshi Fukumasa
- Children's Medical Center, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Masayoshi Tsuda
- Department of Plastic Surgery, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Ryo Ninomiya
- Division of Critical Care Medicine, National Center for Child Health and Development, Ohkura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Masashi Kobayashi
- Children's Medical Center, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Kazutaka Nishiyama
- Children's Medical Center, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Ayami Ito
- Department of Plastic Surgery, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Yukihiro Tasaki
- Department of Plastic Surgery, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
| | - Masano Amamoto
- Children's Medical Center, Kitakyushu City Yahata Hospital, 2-6-2 Ogura, Yahatahigashi-ku, Kitakyushu City, Fukuoka, 805-8534, Japan.
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Indigenous Management of Parotid Sialocele Using Foley's Catheter: A Report of Two Cases. J Maxillofac Oral Surg 2020; 19:225-229. [PMID: 32346231 DOI: 10.1007/s12663-019-01192-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 01/24/2019] [Indexed: 10/27/2022] Open
Abstract
Background Parotid gland and duct injuries are rare complications following surgery of parotid gland and temporomandibular joint. Sialocele is a cavity filled with saliva, usually formed as a result of trauma to salivary gland/duct or an iatrogenic complication of surgery. Several methods of managing parotid duct injury have been reported in the literature. In this article, we describe an indigenous way of internalisation of salivary fistula that resulted from traumatic injury to the parotid duct. Methods The authors present two cases of parotid sialocele managed using Foley's catheter through an intraoral opening, and catheter was internalised, secured and left in situ for 15 days. Results The salivary flow was found to be normal through the intraoral opening, and no recurrence was observed postoperatively. Conclusion Parotid duct injury associated with sialocele and cutaneous salivary fistula could be effectively internalised using Foley's catheter, under local anaesthesia. This technique of internalisation of parotid sialocele is simple, less invasive and may be performed as an outpatient procedure.
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Vazirnia A, Braz A, Fabi SG. Nonsurgical jawline rejuvenation using injectable fillers. J Cosmet Dermatol 2020; 19:1940-1947. [PMID: 31889377 DOI: 10.1111/jocd.13277] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/24/2019] [Accepted: 12/12/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND A well-defined jawline is a critical component in the perception of facial attractiveness in both men and women. Dermal fillers offer a nonsurgical, temporary method of correcting mild-to-moderate mandibular bone resorption. AIMS The authors discuss pertinent aspects of anatomy, pathophysiology of aging, patient evaluation, gender considerations, injection technique, and complications in jawline augmentation using injectable fillers. METHODS A brief review of the literature surrounding jawline augmentation using injectable fillers in both men and women, as well as the authors' experience in this area, is provided. RESULTS Nonsurgical jawline augmentation using injectable fillers can be performed effectively and safely with adequate background knowledge of the regional anatomy and appropriate patient selection. The authors discuss both injection techniques in the published literature and their own approach. Potential complications are also reviewed. CONCLUSION Jawline rejuvenation is a key component to global facial aesthetic rejuvenation. Therefore, it is important for physicians to understand how to safely and effectively perform nonsurgical jawline rejuvenation using injectable fillers.
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Affiliation(s)
- Aria Vazirnia
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - André Braz
- Dermatology Division, Policlínica Geral do Rio de Janeiro (PGRJ), Rio de Janiero, Brazil
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Tsai CH, Ting CC, Wu SY, Chiu JY, Chen H, Igawa K, Lan TH, Chen CM, Takato T, Hoshi K, Ko EC. Clinical significance of buccal branches of the facial nerve and their relationship with the emergence of Stensen's duct: An anatomical study on adult Taiwanese cadavers. J Craniomaxillofac Surg 2019; 47:1809-1818. [DOI: 10.1016/j.jcms.2018.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 12/02/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022] Open
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18
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Robardey G, Le Roux M, Foletti J, Graillon N, Gormezano M, Varoquaux A, Lan R, Chossegros C. The Stensen's duct line: A landmark in parotid duct and gland injury and surgery. A prospective anatomical, clinical and radiological study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:337-340. [DOI: 10.1016/j.jormas.2019.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
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19
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Lesions of the Parotid Gland and Buccal Artery After Buccal Fat Pad Reduction. J Craniofac Surg 2019; 30:790-792. [DOI: 10.1097/scs.0000000000004880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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Kim JW, Kim TG. Immediate parotid duct reconstruction using an autologous vena comitans of the anterolateral thigh free flap pedicle in ablative head and neck surgery. Arch Craniofac Surg 2018; 19:309-310. [PMID: 30613097 PMCID: PMC6325324 DOI: 10.7181/acfs.2018.02117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/02/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jae-Won Kim
- Department of Plastic and Reconstructive Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
| | - Tae-Gon Kim
- Department of Plastic and Reconstructive Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
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21
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Jeong J, Almansoori AA, Park HS, Byun SH, Min SK, Choung HW, Park JY, Choi SW, Kim B, Kim SM, Lee JH. Per-oral cross-facial sural nerve graft for facial reanimation. Maxillofac Plast Reconstr Surg 2018; 40:22. [PMID: 30206538 PMCID: PMC6127071 DOI: 10.1186/s40902-018-0163-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/02/2018] [Indexed: 11/27/2022] Open
Abstract
Background Cross-facial nerve graft is considered the treatment of choice for facial reanimation in patients with unilateral facial palsy caused by central facial nerve damage. In most cases, a traditional parotidectomy skin incision is used to locate the buccal and zygomatic branches of the facial nerve. Methods In this study, cross-facial nerve graft with the sural nerve was planned for three patients with facial palsy through an intraoral approach. Results An incision was made on the buccal cheek mucosa, and the dissection was performed to locate the buccal branch of the facial nerve. The parotid papillae and parotid duct were used as anatomic landmarks to locate the buccal branch. Conclusions The intraoral approach is more advantageous than the conventional extraoral approach because of clear anatomic marker (parotid papilla), invisible postoperative scar, reduced tissue damage from dissection, and reduced operating time.
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Affiliation(s)
- Joohee Jeong
- 2Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Akram Abdo Almansoori
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea
| | - Hyun-Soo Park
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea
| | - Soo-Hwan Byun
- 5Department of Oral and Maxillofacial Surgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, South Korea
| | - Seung-Ki Min
- 2Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Han-Wool Choung
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea
| | - Joo Yong Park
- 2Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Sung Weon Choi
- 2Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Bongju Kim
- 6Dental Life Science Research Institute, Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, South Korea
| | - Soung-Min Kim
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea.,4Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Jong-Ho Lee
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea.,3Oral Cancer Center & Clinical Trial Center, Seoul National University Dental Hospital, Seoul, South Korea.,4Dental Research Institute, Seoul National University, Seoul, South Korea
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Hu CY, Shang ZJ, Qin X, Shao LN. Application of Delayed Surgical Managements in Patients with Stensen's Duct Injury. Curr Med Sci 2018; 38:519-523. [PMID: 30074221 DOI: 10.1007/s11596-018-1909-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/20/2018] [Indexed: 10/28/2022]
Abstract
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with 1- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen's duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
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Affiliation(s)
- Chuan-Yu Hu
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.,Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng-Jun Shang
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.
| | - Xu Qin
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Le-Nan Shao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Medeiros Paz ALL, Caetano RDS, Borges AH, Ricci Volpato LE. Reconstruction of the Parotid Duct. Ann Maxillofac Surg 2018; 8:140-142. [PMID: 29963442 PMCID: PMC6018291 DOI: 10.4103/ams.ams_24_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The most common causes of parotid duct lesions are injuries with sharp instruments. Late alterations after such lesions lead to esthetic defects and complicates the treatment. This case report presents an alternative surgical technique for late reparation of the parotid duct. A 31-year-old male patient was admitted with a history of physical aggression by a glass bottle, resulting in cutting injuries in face and drainage of extraoral transparent fluid from the buccinatory region lesion Antibiotic therapy was initiated immediately, and the surgery was performed nine days after the incident. The repair of the parotid duct lesion was achieved adapting a venous catheter that was passed through the distal portion of the duct from the oral orifice. The proximal segment of the duct was cannulated, the lacerated ends of the duct were approximated on the device and sutured with prolipopylene thread. At the 14-day post-operative return, the saliva was draining through the catheter, and then it was removed. Patients with cutaneous lesions in the buccinatory region require a thorough examination to identify injuries to the parotid duct. The surgical treatment using the presented alternative surgical technique was an effective and cheaper option when compared to other alternatives and showed no complications.
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Affiliation(s)
| | | | - Alvaro Henrique Borges
- Master's Program in Integrated Dental Sciences of The University of Cuiabá, Cuiabá, MT, Brazil
| | - Luiz Evaristo Ricci Volpato
- Mato Grosso Cancer Hospital, Cuiabá, MT, Brazil.,Master's Program in Integrated Dental Sciences of The University of Cuiabá, Cuiabá, MT, Brazil
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Tandon P, Saluja H, Shah S, Dadhich A, Sachdeva S. Catheterization of post infection parotid duct sialocele with paediatric Ryles tube: A case report. J Oral Biol Craniofac Res 2017; 8:217-220. [PMID: 30191112 DOI: 10.1016/j.jobcr.2017.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022] Open
Abstract
Sialocele is a cavity filled with saliva, usually as a result of trauma, complication of surgery, sialolithiasis or bacterial infection residing inside the duct. Many cases of parotid sialocele have been reported in the literature, but only very few cases of parotid duct sialocele have been reported. We report a case of an unusual facial swelling over buccal mucosa at the route of Stenson's duct with poor oral hygiene, a case of parotid duct sialocele with secondary infection and describe its diagnosis and management.
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Affiliation(s)
- Parul Tandon
- Department of oral & maxillofacial surgery, Rural dental college, PIMS, Loni, Maharashtra 413736, India
| | - Harish Saluja
- Department of oral & maxillofacial surgery, Rural dental college, PIMS, Loni, Maharashtra 413736, India
| | - Seemit Shah
- Department of oral & maxillofacial surgery, Rural dental college, PIMS, Loni, Maharashtra 413736, India
| | - Anuj Dadhich
- Department of oral & maxillofacial surgery, Rural dental college, PIMS, Loni, Maharashtra 413736, India
| | - Shivani Sachdeva
- Department of Periodontology, Rural dental college, PIMS, Loni, Maharashtra 413736, India
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25
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Affiliation(s)
| | - Robinder Singh
- Medical University of South Carolina Charleston, South Carolina
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26
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Rajeev R, Sajesh S, Jose M, Kumar ND. Sialocele: A rare sequlae of transparotid approach in subcondylar fracture management. Natl J Maxillofac Surg 2017; 7:201-204. [PMID: 28356695 PMCID: PMC5357935 DOI: 10.4103/0975-5950.201363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Iatrogenic injury and/or damage to the parotid salivary gland during transparotid approach for open reduction and internal fixation of mandibular condyle fracture is a rare event. Accumulation of saliva in the gland leads to formation of a sialocele. Huge sialocele often seeks drain through the most dependent area through an extraoral wound, whereas in the absence of extraoral fistula, saliva can be redirected intraorally using a stent. A case of mangement of sialocele caused by damage to glandular elements during a transparotid approach for a subcondylar fracture reduction is reported. The various conservative methods and surgical management for this condition are discussed.
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Affiliation(s)
- R Rajeev
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - S Sajesh
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - Mathew Jose
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - N Dhineksh Kumar
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
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Masseteric Myositis: A Unique Cause of Obstructive Sialadenitis of Parotid Gland. J Craniofac Surg 2017; 28:580. [PMID: 28068299 DOI: 10.1097/scs.0000000000002972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Öztürk MB, Barutca SA, Keskin ES, Atik B. Parotid Duct Repair with Intubation Tube: Technical Note. Ann Maxillofac Surg 2017; 7:129-131. [PMID: 28713751 PMCID: PMC5502500 DOI: 10.4103/ams.ams_166_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The parotid duct can be damaged in traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great importance because complications such as sialocele and salivary gland fistula may develop if the duct is not surgically repaired. We think the cuff of an intubation tube is an ideal material in parotid duct repair, because of its technical characteristics, easiness of availability, and low-cost. In this paper, we described the use of the cuff cannula of an intubation tube for the diagnosis and treatment of parotid duct laceration, as a low-cost and easy to access material readily available in every operating room.
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Affiliation(s)
| | | | - Elif Seda Keskin
- Plastic Surgery, Istanbul Medeniyet Üniversitesi, İstanbul, Turkey
| | - Bekir Atik
- Plastic Surgery, Istanbul Medeniyet Üniversitesi, İstanbul, Turkey
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Highstein M, Tham T, Singh P, Costantino P. Parotid duct injury secondary to shark bite injury: Repair with a Crawford stent. JPRAS Open 2016. [DOI: 10.1016/j.jpra.2016.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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Melville JC, Stackowicz DJ, Jundt JS, Shum JW. Use of Botox (OnabotulinumtoxinA) for the Treatment of Parotid Sialocele and Fistula After Extirpation of Buccal Squamous Cell Carcinoma With Immediate Reconstruction Using Microvascular Free Flap: A Report of 3 Cases. J Oral Maxillofac Surg 2016; 74:1678-86. [DOI: 10.1016/j.joms.2016.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/22/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
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Surgical management of Stenson's duct injury by using double J stent urethral catheter. Int J Surg Case Rep 2015; 17:75-8. [PMID: 26555062 PMCID: PMC4701807 DOI: 10.1016/j.ijscr.2015.10.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 11/28/2022] Open
Abstract
The safety and efficiency of using normal saline in diagnosis of parotid duct injury instead of methylene blue dye, milk and propofol. Using of double J stent urethral catheter in the diagnosis and repair of the parotid duct during traumatic facial and/or parotid injuries is a valuable technique to be used in the surgical practice. Early diagnosis and urgent repair of the parotid duct injury enhance the functional recovery of the parotid duct.
Background Parotid duct or gland injury can be caused by assault with a knife, bottle, electrical-saw, road traffic accident, or rarely gunshot and fractures of the facial skeleton. The injury can be in the form of laceration, ductal exposure, total cutting, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable forms of the injury. A successful management of parotid duct injuries depends on early diagnosis and appropriate intervention; improper surgery may lead to complications such as sialocele or salivary fistula Case report A 27-years-old man was presented to the maxillofacial unit, complaining of bleeding over the right side of his face after accidental exposure to a chain-saw three hours before admission. On examination, a 6 cm deep lacerated wound was found over the right buccal area, suspecting facial nerve-buccal branch and parotid duct injury. Under general anesthesia the parotid duct injury diagnosed, microsurgical anastomosis of the cut-ends of the parotid duct performed using the double J catheter. Sutures and JJ stent removed seven and twenty postoperative days respectively. After a proper supportive treatment a complete healing of the duct was obtained with normal amount of saliva. Conclusions Herein, we described an easy yet efficient technique in management of parotid duct injury using a JJ stent which is often used for urethra. We think that use of JJ stent is a valuable technique to be used in the diagnosis and surgical repair of the parotid duct during traumatic facial and/or parotid injuries.
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Toure G, Foy JP, Vacher C. Surface anatomy of the parotid duct and its clinical relevance. Clin Anat 2015; 28:455-9. [DOI: 10.1002/ca.22510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 12/15/2014] [Accepted: 12/17/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Gaoussou Toure
- Service de Chirurgie Maxillo-Faciale; 40 Allée de la Source, CHI L & R Aubrac 94195 Villeneuve-Saint-Georges Cedex France
- URDIA; EA 4465; Université Paris 5; Paris France
| | - Jean-Philippe Foy
- Service de Chirurgie Maxillo-Faciale; 40 Allée de la Source, CHI L & R Aubrac 94195 Villeneuve-Saint-Georges Cedex France
| | - Christian Vacher
- Université Paris 7, Service de Chirurgie Maxillofaciale, Hôpital Beaujon; 100 bd du Général Leclerc 92110 Clichy France
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Donoso T, Domancic S, Argandoña J. Delayed Treatment of Parotid Sialocele: A Functional Approach and Review. J Oral Maxillofac Surg 2015; 73:284-90. [DOI: 10.1016/j.joms.2014.08.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/28/2014] [Accepted: 08/30/2014] [Indexed: 11/28/2022]
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Kulkarni A, Chandrasala S, Nimbeni BS, Singh SP, Golai S. Management of an unusual case of iatrogenic parotid sialocele using an infant feeding tube: a novel approach. BMJ Case Rep 2014; 2014:bcr-2014-205845. [PMID: 25331148 DOI: 10.1136/bcr-2014-205845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Injuries to the parotid duct and parenchyma resulting in swelling in the cheek region commonly present in maxillofacial practice. Sialocele is a discrete collection of saliva in a subcutaneous cavity that can be iatrogenic, idiopathic or the result of post-traumatic injuries to the duct or parenchyma, presenting as a salivary pseudocyst or retention cyst. We present an unusual case of parotid sialocele following surgery for sialolithiasis which presented with progressive painless swelling in the preauricular region of 9 months duration. Treatment included surgical exploration under local anaesthesia and draining the cavity by keeping the opening patent using an infant feeding tube.
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Affiliation(s)
- Ambadas Kulkarni
- Oral and Maxillofacial Surgery, Government Dental College, Calicut, India
| | | | - Basavaraj S Nimbeni
- Pedodontics and Preventive Dentistry, AME's Dental College Hospital & Research Centre, Raichur, Karnataka, India
| | | | - Shruti Golai
- Pedodontics and Preventive Dentistry, AME's Dental College Hospital & Research Centre, Raichur, Karnataka, India
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Postauricular Approach for Mandibular Angle Ostectomy: An Alternative for Shortening the Recovery Time. Ann Plast Surg 2014; 76:23-8. [PMID: 25325390 DOI: 10.1097/sap.0000000000000216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Many surgical procedures to improve mandibular contour have been introduced in East Asia. Despite consensus regarding mandible contouring surgery, surgery which includes angle ostectomy and lateral cortex excision, some patients require only mandibular angle ostectomy. The intraoral approach is a widely used method, but has disadvantages with regard to the need for endotracheal intubation and patients are limited in their food intake for a considerable length of time. The authors wanted to shorten the recovery period and so the postauricular approach is introduced in this study and assessed.One hundred seventy-five Asian patients underwent mandibular angle ostectomy via a postauricular approach. All operations were performed under intravenous sedation without endotracheal intubation. Superficial subcutaneous dissection and vertical dissection were performed, with special care taken to avoid injuring the facial nerve. Patients responded to a simple questionnaire during the postoperative period. Questions solicited the patient's reason for their choice of this approach and their satisfaction with it.No visible scar and no palpable bony step were observed without ear pulling. Some patients experienced temporary sensory changes in the postauricular area. None of the patients complained of perioral numbness or facial paralysis. Six patients had significant bleeding in the operative field and 1 patient experienced salivary leakage for 2 weeks which was managed well without event. Of the 175 patients, 133 responded to the questionnaire. Satisfaction was expressed by 94.7% of patients and 88.7% of patients would recommend this surgery to their friends; 69.2% of patients experienced inconvenience for 1 week or less.The postauricular approach for mandibular angle ostectomy is a very convenient method for surgeons to use for patients who want to undergo mandibular angle ostectomy with a short recovery time.
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Kulyapina A, Lopez-de-Atalaya J, Ochandiano-Caicoya S, Navarro-Cuellar C, Navarro-Vila C. Iatrogenic salivary duct injury in head and neck cancer patients: Report of four cases and review of the literature. J Clin Exp Dent 2014; 6:e291-4. [PMID: 25136433 PMCID: PMC4134861 DOI: 10.4317/jced.51438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 02/09/2014] [Indexed: 11/21/2022] Open
Abstract
Introduction: The lesions of the salivary ducts may be idiopathic, post- traumatic, or iatrogenic and lead to sialocele formation with persistent painful facial swelling or cutaneous fistula formation. No consensus on treatment of this condition exists: the options of treatment include needle aspiration, pressure dressings, antisialogogue therapy, radiotherapy, botulinum toxin and surgical approaches as duct repair, diversion, ligation, different drainage systems and even parotidectomy/submaxilectomy. The management and special features of iatrogenic salivary duct injury in patients with oral cancer who underwent head and neck reconstructive surgery has not been described yet.
Material and Methods: We present four cases of iatrogenic lesions of salivary ducts and its management in patients with oral cancer.
Conclusions: The iatrogenic lesions of salivary ducts are to be taken into account in patients with oral cancer as the distal ends of salivary ducts could be involved in the margins of surgical resection. Different options of treatment of this complication are described.
Key words:Sialocele, oral cancer, salivary duct.
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Affiliation(s)
- Alena Kulyapina
- Resident Physician in Oral and Maxillofacial Surgery. Department of Oral and Maxillofacial Surgery. Gregorio Marañon, General University Hospital. Madrid. Spain
| | - Javier Lopez-de-Atalaya
- MD, PhD. Department of Oral and Maxillofacial Surgery. Gregorio Marañon, General University Hospital. Madrid. Spain
| | - Santiago Ochandiano-Caicoya
- MD. Department of Oral and Maxillofacial Surgery. Gregorio Marañon, General University Hospital. Madrid. Spain
| | - Carlos Navarro-Cuellar
- MD, PhD. Department of Oral and Maxillofacial Surgery. Gregorio Marañon, General University Hospital. Madrid. Spain
| | - Carlos Navarro-Vila
- MD. Department of Oral and Maxillofacial Surgery. Gregorio Marañon, General University Hospital. Madrid. Spain
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Koch M, Iro H, Bozzato A, Zenk J. Sialendoscopy-assisted microsurgical repair of traumatic transection of Stensen's duct. Laryngoscope 2013; 123:3074-7. [DOI: 10.1002/lary.23412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 04/05/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Koch
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology-Head and Neck Surgery; Friedrich Alexander University of Erlangen-Nuremberg, Medical School; Erlangen Germany
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Stensen's duct injuries: the role of sialendoscopy and adjuvant botulinum toxin injection. Wideochir Inne Tech Maloinwazyjne 2013; 8:112-6. [PMID: 23837095 PMCID: PMC3699770 DOI: 10.5114/wiitm.2011.32851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 12/17/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Stensen's duct injuries are uncommon but troublesome sequelae of facial surgery or other external traumas. AIM To investigate the feasibility of sialendoscopic control of Stensen's duct in iatrogenic injuries and the efficiency of botulinum toxin adjuvant therapy. MATERIAL AND METHODS In 2008 and 2010, 5 patients with parotid sialoceles or fistulas, infrequent complications after plastic surgery or trauma, were treated in a single institution, Poznan University of Medical Sciences ENT Department. The group consisted of 5 patients with diagnosed Stensen's duct injuries, which were post-surgery and post-traumatic sequelae. All were treated by means of open surgery. Botulinum toxin injection was administered during the procedure to decrease the saliva secretion and to improve the healing process. A sialendoscopy was performed to control the lumen of the junction after the duct injury was repaired. RESULTS Complete healing of the fistulas and sialoceles after the reparative surgery followed by a single botulinum toxin application was observed in all patients within 10-14 days. No side effects were noticed. CONCLUSIONS Our findings suggest that sialendoscopy is a valuable tool and an important step of control in the surgery of parotid duct injuries and the injection of botulinum toxin is an effective and safe second-line treatment.
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Torre-León C, Canario Q, Garratón M. A Novel Approach in the Treatment of a Posttraumatic Sialocele. Otolaryngol Head Neck Surg 2012; 148:529-30. [DOI: 10.1177/0194599812470435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Carlos Torre-León
- Otolaryngology–Head and Neck Surgery, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico
| | - Quirico Canario
- Department of General Surgery, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico
| | - Miguel Garratón
- Otolaryngology–Head and Neck Surgery, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico
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Lazaridou M, Iliopoulos C, Antoniades K, Tilaveridis I, Dimitrakopoulos I, Lazaridis N. Salivary gland trauma: a review of diagnosis and treatment. Craniomaxillofac Trauma Reconstr 2012; 5:189-96. [PMID: 24294401 DOI: 10.1055/s-0032-1313356] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Accepted: 08/16/2011] [Indexed: 10/28/2022] Open
Abstract
Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.
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Affiliation(s)
- Maria Lazaridou
- Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Hogg NJV. Primary and secondary management of pediatric soft tissue injuries. Oral Maxillofac Surg Clin North Am 2012; 24:365-75. [PMID: 22695255 DOI: 10.1016/j.coms.2012.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Injury is the most common cause of death in pediatric patients, with a large proportion related to head injury. The craniofacial region in children develops rapidly and at an early age, making the area more prominent compared with the remainder of the body, increasing the likelihood of injury. This article reviews the primary management of pediatric soft tissue injuries, including assessment, cleansing, surgical technique, anesthesia, and considerations for special wounds. The secondary management of pediatric facial injury is also discussed, including scar revision, management of scar hypertrophy/keloids, and staged surgical correction.
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Barbosa DC, Júnior RM, Carvalho EJA, de Carvalho AAT. Catheterization of Stenon's duct for surgical excision of oral fibroepithelial hyperplasia. Braz J Otorhinolaryngol 2012. [PMID: 22392253 PMCID: PMC9443903 DOI: 10.1590/s1808-86942012000100023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Vasconez HC, Buseman JL, Cunningham LL. Management of Facial Soft Tissue Injuries in Children. J Craniofac Surg 2011; 22:1320-6. [DOI: 10.1097/scs.0b013e31821c9377] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Sujeeth S, Dindawar S. Parotid duct repair using an epidural catheter. Int J Oral Maxillofac Surg 2011; 40:747-8. [DOI: 10.1016/j.ijom.2011.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 02/03/2011] [Indexed: 10/18/2022]
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Abstract
As the incidence of facial skin tumors is rising, otorhinolaryngologists are becoming more and more involved in the field of facial plastic surgery. The most common tumor locations on the head are the sun-exposed areas such as the nose, forehead, cheek, and auricle. The most common histologic findings are actinic keratosis and basal cell carcinoma. In planning tumor resection and defect repair, many factors, including histology, size, and localization of the tumor as well as conditions of the adjacent skin, must be considered. The key to defect repair after tumor resection is to choose the most appropriate technique from a range of possibilities. Because of skin laxity, most small and midsize facial defects can be closed directly or with high-tension sutures under skin expansion. More extensive defects and those located in critical areas require pedicled flaps or free grafts transferring skin from adjacent or distant areas. In patients with recurrent or deeply infiltrative tumors, reconstructive procedures of the facial nerve, parotid duct, and lacrimal duct might be needed. This is also true for reconstruction of the anatomic framework of the eyelids, the nose, and the pinna.
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Reconstruction after wide excision of primary cutaneous melanomas: part I—the head and neck. Lancet Oncol 2009; 10:700-8. [DOI: 10.1016/s1470-2045(09)70116-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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