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Salivary Gland Tumours
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Salivary fistula or collection (sialocele): Sialocele occurs a few days after surgery and can be tense and painful. Collections are aspirated, and aspiration may need repeating. Antibiotics may be considered to prevent/treat secondary infection. Hyoscine patches or botulinum toxin injection can reduce saliva production. Both leaks and collections almost always settle.
Benign Salivary Gland Tumours
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Except in total parotidectomy, there will always be a cut surface of the parotid gland from which saliva will leak. This saliva can form a collection (sialocoele) (Figure 9.10) or leak through the incision (fistula). When this occurs, it tends to occur within a few days of the surgery. A collection can be quite tense and painful, especially when eating. Collections are aspirated in clinic and this may need to be repeated on several occasions. A leak will need appropriate dressing and maintenance of wound hygiene. Antibiotics should be considered to prevent or treat secondary infection that can occur. Both leaks and collections almost always settle, but it can take 1–2 weeks. Quite why salivary fistulas are not more common is unknown. It could be speculated that those with a significant volume of residual gland, perhaps with an extensive cut surface are more prone to the complication. If there has been ligation of the duct, then it will always happen. Hyoscine patches can be used to reduce saliva production. The next line of treatment when the fistula does not settle conservatively is to inject Botulinum toxin into the main/residual parotid gland (under ultrasound control) and this essentially stops saliva production within a few days and reverses with time (2–3 months).
Analysis of clinical characteristics and management of ectopic third molars in the mandibular jaw: a systematic review of clinical cases
Published in Acta Odontologica Scandinavica, 2021
Suresh Kandagal Veerabhadrappa, Priyadarshini Hesarghatta Ramamurthy, Seema Yadav, Ahmad Termizi Bin Zamzuri
The extra-oral approach was most preferred for EMTM in the condylar/sub condylar, high in the ramus and lower border of the mandible areas, as these regions were the most difficult to visualize from the intraoral approach [42]. It provides better exposure of the surgical field, more control over the surgical plane, less bone removal, and helps to apply rigid fixation to prevent or treat iatrogenic fracture [22,27]. However, there will be a skin scar, a risk of damage to the marginal mandibular branch of the facial nerve, and TMJ components [1]. Infrequently, damage to the parotid capsule leading to sialocele formation was observed in one case [27]. Hunsuck sagittal split ramus osteotomy can be considered in deeply impacted EMTM and cases requiring extensive removal of alveolar bone [22]. Interestingly, one EMTM tooth with large radiolucency showed spontaneous regression over 6 years due to the decrease in the intracystic hydrostatic pressure after the disruption of the cystic wall leading to drainage and decompression [18]. About 10% of the asymptomatic EMTM teeth were not provided with any treatment. These teeth without any lesions need to be monitored with follow-up at regular intervals [1].
A modified V-shaped incision combined with superficial musculo-aponeurotic system flap for parotidectomy
Published in Acta Oto-Laryngologica, 2019
Min-Gyu Jo, Dong-Joo Lee, Wonjae Cha
No transient or permanent facial paralysis was reported in the modified VSI group. And there was no intraoperative tumor rupture, and clear resection margin was pathologically confirmed in all cases. Furthermore, no statistically significant differences in minor complications, such as hematoma, infection, wound dehiscence, skin necrosis, sialocele, Frey syndrome, and sensory disturbance between the two groups were noted. Sialocele occurred in five cases (14.7%) in the modified VSI approach, and was easily managed with one or two aspirations in the outpatient clinic. The only visible area of the scar in the modified VSI approach was just anterior to the ear lobule (Figures 2 and 3). No undesirable scar such as hypertrophic scarring or keloid developed in this area. Most patients were satisfied with their results (cosmetic satisfaction score, VAS: 9.2). Our results demonstrated that the modified VSI approach might be technically feasible and its surgical safety would be comparable to the standard approach.