[Parotid fistulas: therapeutic result].
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Five patients with bilateral chronic recurrent parotiditis and ten patients with unilateral persistent paratoid gland fistulas underwent tympanic neurectomies. Two biopsy specimens from the diseased gland were examined. The first biopsy specimen was taken at the time of operation, while the second one was taken six months later. All specimens were subjected to both histopathologic and histochemical investigations. Definite degenerative and atrophic changes occured in all parotid gland specimens taken six months after selective tympanic neurectomy. All patients were completely cured at about that time. This supported the practical indication of the selective tympanic neurectomy for treating certain benign disorders or diseases of the parotid gland that require persistent arrest of the function of its secretory units.
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A rare case of a salivary megalith with a sialo-cutaneous and a sialo-oral fistula in an elderly man is presented. A brief review of the literature is made.
Extraoral fistulas, whether primary or as the residue of an abscess, have different causes. According to case reports in the literature and from clinical experience the dentogenous cause is the more frequent. For this reason a possible tooth involvement should be ruled out before therapy, loss of dental pulp of various origin and periodontal diseases should be excluded, otherwise the treatment must begin with the cause, after which further intervention is usually superfluous.
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An extremely rare case of a cutaneous fistula of the submandibular salivary gland is presented. The etiology of the fistula was a foreign body in Wharton's duct. We describe the clinical course, management and histo-pathological findings.
Today parotidectomy is a common, safe surgical procedure. With the increase in the number of parotidectomies being performed there have been many reviews of both the immediate and delayed operative complications. Postoperative salivary fistula, although a common occurrence, is usually glossed over or barely mentioned in most reviews. The present study reviews the parotid experience at a major teaching hospital, The Wellesley Hospital, University of Toronto, over a 10-year period. This information was used to draw general conclusions concerning the incidence, etiology and treatment of salivary fistulas as well as their prevention.
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Suppression of salivary flow is of value in the management of salivary fistulae and sialectasia. It may also be beneficial in mentally defective patients and those with neurological palsies lacking control of their salivation. Nine patients were treated by irradiation to the parotid gland to control salivary flow; eight had complete resolution of symptoms and one had partial relief. Irradiation was effective as primary treatment and after failed surgery and/or drug treatment. Low doses were effective and there were no significant acute or long-term side effects. Its use avoids long-term medication and their potential side effects and may reduce the need for surgery.
Spontaneous salivary fistulas are rare. Extremely rare are spontaneous salivary fistulas of the external auditory canal. We report a case of otorrhoea caused by such a fistula in connection with defects of the cartilagenous and the osseous external auditory canal (Fissures of Santorini, foramen of Huschke) and its successful surgical treatment.