Endoscopic Treatment of Salivary Gland Injuries due to Facial Rejuvenation Procedures

Abstract

The main reasons for salivary gland injuries due to facial rejuvenation procedures in our patients were: poor anatomical identification of the border between the superficial muscular aponeurotic system (SMAS) and the parotid capsule; penetration of the salivary gland capsule by blunt or sharp dissection; unnecessary use of sharp-tip scissors; and a tear of the salivary duct by hooks during a face-lift procedure. Plastic surgeons should be aware of these complications and try to improve their techniques accordingly. To avoid atrophy of the salivary gland, once the diagnosis it made, it is advisable to send the patient to a maxillofacial or ENT surgeon skilled in endoscopy.

Redefining the Surface Anatomy of the Parotid Duct

“…19,40,41 Procedures in which the parotid duct is at risk of iatrogenic injury or transection include injection of botulinum toxin for masseter muscle disorders 4 and facial rejuvenation operations such as rhytidectomy. 5,6,42 CONCLUSIONS Current surface markings for the parotid duct in adults are inaccurate. In most individuals, the duct is better represented as lying within 1.5 cm of the middle half of a line between the lower border of the tragus and the angle of the mouth (Fig.…”

“…3 The duct may be severed by a facial laceration and is also at risk of iatrogenic injury during injection of botulinum toxin into the masseter muscle 4 and facial rejuvenation surgery. 5,6 Accurate knowledge of its surface anatomy is therefore important. However, the surface marking of the duct varies between and within some reference texts in head and neck/otolaryngology, 7-10 maxillofacial surgery, [11][12][13] plastic surgery, 14,15 and anatomy.…”

Surface anatomy of the parotid duct and its clinical relevance

“…It can also be injured as a result of facial trauma, particularly in the case of wounds to the parotidomasseteric or buccal areas, which can lead to complications such as sialocele, salivary pseudo‐cyst, or salivary fistula (Barton et al, ; Lewis and Knottenbelt, ; Steinberg and Herréra, ; Sujeeth and Dindawar, ). Cases of sialocele resulting from facial rejuvenation procedures have also been reported, while PD laceration or compression have been observed with rhytidectomies (Nahlieli et al, ) and with Aptos thread techniques (Winkler et al, ). Injuries to the PD are also quite frequent during cutaneous tumor surgery, especially during Mohs procedures (Krishnan et al, ).…”

“…E-mail: gaoussou. toure@chiv.fr procedures have also been reported, while PD laceration or compression have been observed with rhytidectomies (Nahlieli et al, 2008) and with Aptos thread techniques (Winkler et al, 2006). Injuries to the PD are also quite frequent during cutaneous tumor surgery, especially during Mohs procedures (Krishnan et al, 2009).…”

A Giant Sialocele Caused By a Stab Wound: Case Report

“…4 In such cases, the insertion of drains to create a new salivary duct, low-level radiation to stop the secretion of saliva and induce the glandular start fibrosis, tympanic neurectomy to stop the parotid gland secretion and partial or total parotidectomy are suggested. 16 Monfared et al have described intraoral sialocele marsupialization with leaving a drain in the mouth. 5 Treatment of sialocele with intraoral parotid duct catheterization as reported in the present case, has been also reported with successful results without recurrence in several articles.…”