eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Trauma

Parotid Duct Injuries: Follow-up

Author: Jose E Barrera, MD, Instructor, Department of Otolaryngology-Head and Neck Surgery, Stanford University
Coauthor(s): Don R Revis Jr, MD, Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine; Michael Brent Seagle, MD, Associate Professor, Division of Plastic Surgery, University of Florida College of Medicine; Consulting Staff, Florida Surgical Center
Contributor Information and Disclosures

Updated: May 21, 2008

Future and Controversies

Some controversy exists regarding optimal treatment of isolated parotid duct injuries. Most authors agree that the treatment of choice is immediate repair over a stent whenever possible, and certainly this is indicated if other injuries, such as facial nerve injuries, are present and require surgical intervention. At least one study, however, documents successful expectant treatment of isolated parotid duct injuries.5 Immediate repair may prevent some complications, such as fistula or sialocele formation, but it also places the patient at risk for other complications, such as iatrogenic facial nerve injury, even in experienced hands.

Exploration and repair also involves significantly increased costs because this requires surgery and inpatient care, whereas expectant care is managed on an outpatient basis. On the other hand, a missed injury requires treatment that is also costly—not just financially but also in terms of quality of life. The responsible physician must decide which treatment plan is appropriate to each unique patient-care situation. Certainly, wounds older than 24 hours should probably be managed expectantly because many will heal without untoward event.

 


More on Parotid Duct Injuries

Overview: Parotid Duct Injuries
Workup: Parotid Duct Injuries
Treatment: Parotid Duct Injuries
Follow-up: Parotid Duct Injuries
Multimedia: Parotid Duct Injuries
References
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References

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  3. Doctor VS, Rafii A, Enepekides DJ, Tollefson TT. Intraoral transposition of traumatic parotid duct fistula. Arch Facial Plast Surg. Jan-Feb 2007;9(1):44-7. [Medline].

  4. Arnaud S, Batifol D, Goudot P, Yachouh J. [Non-surgical management of parotid gland and duct injuries: interest of botulinum toxin]. Ann Chir Plast Esthet. Feb 2008;53(1):36-40. [Medline].

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Further Reading

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Keywords

parotid duct injuries, Stenson duct injuries, salivary gland, parotid fistula, sialocele, parotid duct, Stenson duct, parotid gland, salivary gland injuries, salivary gland injury

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Contributor Information and Disclosures

Author

Jose E Barrera, MD, Instructor, Department of Otolaryngology-Head and Neck Surgery, Stanford University
Jose E Barrera, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Academy of Sleep Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Don R Revis Jr, MD, Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine
Don R Revis Jr, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Michael Brent Seagle, MD, Associate Professor, Division of Plastic Surgery, University of Florida College of Medicine; Consulting Staff, Florida Surgical Center
Michael Brent Seagle, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society of Plastic and Reconstructive Surgery, and Southeastern Society of Plastic and Reconstructive Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Daniel G Becker, MD, Clinical Associate Professor, Department of Otorhinolaryngology-Head and Neck Surgery, Division of Facial Plastics and Reconstructive Surgery, University of Pennsylvania
Daniel G Becker, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Robert M Kellman, MD, Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York, Upstate Medical University
Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, and Medical Society of the State of New York
Disclosure: GE Healthcare Honoraria Review panel membership

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Advanced Headache Intervention Consulting fee Consulting; Covidien Corp Consulting fee Consulting

 
 
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