Management of parotid fistula using hypertonic saline

Rao, JK Dayashankara; Gehlot, Neelima; Laxmy, Vijay; Siwach, Vijay

doi:10.4103/0975-5950.94477

Cited by 16 publications

(8 citation statements)

References 12 publications

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“…Many a times, decision has to be taken on urgent basis as head injury and other associated life-threatening injuries require urgent operative intervention. [17] The emergency surgery in craniofacial trauma is further warranted by CSF leak which occurs in 11–12% of cases with basal skull fractures,[18] and the incidence in our study prevailed to the extent of 15%. The main goals of neurosurgical intervention at the earliest are to prevent the irreversible pressure changes in the brain, external deformity of the skull, sealing the CSF leak and to avoid meningitis and sinusitis.…”

Section: Discussionmentioning

confidence: 59%

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Clinical and critical care concerns of cranio-facial trauma: A retrospective study in a tertiary care institute

Bajwa

Kaur

Singh

et al. 2012

Natl J Maxillofac Surg

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Background and Objectives:Maxillofacial trauma is commonly associated with other injuries, predominantly head injuries. The predictors of outcome in such concomitant injuries have been studied the least. The present study aims at the evaluation of types of injury, management and outcome of patients sustaining maxillofacial trauma and concomitant cranial injuries.Materials and Methods:A retrospective study was carried out in the department of anesthesiology and intensive care. A case series of 129 patients was evaluated who were admitted in ICU (Intensive Care Unit) with maxillofacial trauma and head injuries. The data was then compiled systematically and analyzed using SPSS windows and value of P < 0.05 was considered significant and P < 0.001 as highly significant.Results:Among the 129 patients, majority of them had roadside accidents (RSA > 90%) and male gender predominance with male to female ratio of 5: 1. Fracture maxilla and nasal bones were the most commonly encountered injuries (51.93%) followed by mandibular fractures (39.53%) and fracture of zygomatic bones (28.68%). Eighty five patients (65.90%) required mechanical ventilation, tracheostomy was needed in 29 (22.48%) patients and 81 (62.8%) patients were operated for head injuries as well. Majority of the victims were aged between 15 and 40 years.Conclusions:Maxillofacial trauma and cranial injuries are common among young males and so is the nature of injuries, that is, RSA. Besides facial injuries, head injuries are important determinant of outcome in such patients. Timely resuscitation and surgical interventions at specialized centers are of prime importance as far as a better prognosis is concerned in such injuries.

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Section: Discussionmentioning

confidence: 59%

“…The controversy is never ending with regards to indication for surgery, timing of surgery, the best operative approach, the choice of material to close dural leaks and bone defects etc. [18]…”

Section: Discussionmentioning

confidence: 99%

Clinical and critical care concerns of cranio-facial trauma: A retrospective study in a tertiary care institute

Bajwa

Kaur

Singh

et al. 2012

Natl J Maxillofac Surg

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“…Follow-up was done for 5 months with no morbidity seen. [ 20 ] The occurrence of such a complication is rare. In a case series of 51 condylar fractures treated by transparotid approach, 1 case of sialocele and 1 case of parotid fistula were observed.…”

Section: Discussionmentioning

confidence: 99%

Unilateral subcondylar and condylar neck fractures: Randomized clinical study

Hakim

Shah

Farooq

et al. 2018

Ann Maxillofac Surg

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Aims and Objectives:The aim of the present study was to compare closed treatment with open reduction internal fixation (ORIF) for subcondylar and condylar neck fractures.Materials and Methods:This randomized prospective study was conducted on thirty patients who visited the Department of Oral and Maxillofacial Surgery, Government Dental College, Srinagar, with condylar fractures. All fractures were displaced; either angulated between 10° and 45° and the ascending ramus was shortened by >2 mm to <15 mm. Patients were divided into two groups after satisfying the inclusion and exclusion criteria – Group I (closed treatment) and Group II (open reduction) (15 implants in each group). In Group I, patients were treated by mandibulo-maxillary fixation using arch bar and elastics for 4 weeks, and in Group II, patients were treated by ORIF using two 1.5-mm miniplates. Follow-up was done at 1 month, 3 months, and 6 months. Our postoperative evaluation included five parameters – maximal interincisal opening, protrusion, lateral excursion on fractured and nonfractured sides, anatomical reduction, and pain and malocclusion. Nonparametric data were compared for statistical significance with Chi square test and parametric data with an independent sample's t-test (P < 0.05).Results:Correct anatomical position of the fragments was achieved significantly more accurately in the operative group in contrast to the closed treatment group. Regarding mouth opening/lateral excursion on fractured and nonfractured sides/protrusion, significant (P < 0.05) differences were observed between both groups (open 39.73/7.50/8.17/7.87 mm vs. closed 36.87/6.07/7.23/7.13 mm). Pain also revealed significant (P = 0.025) difference with less pain in the operative treatment group.Conclusion:Both treatment options for condylar fractures of the mandible yielded acceptable results. However, operative treatment was superior in all objective and subjective functional parameters except occlusion.

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“…[ 7 8 ] Five milliliters of 3% warm hypertonic saline (60°C) was injected into the parotid gland through fistulous opening followed by pressure dressing repeated for 3 days causing fibrosis of gland parenchyma and spontaneous closure of fistula with no complications. [ 9 ] Radiation therapy induces fibrosis and atrophy of the gland. Approximately 1800 rads for more than 6 weeks are required for refractory salivary fistulas.…”

Section: Discussionmentioning

confidence: 99%

Sialocele: A rare sequlae of transparotid approach in subcondylar fracture management

Rajeev

Sajesh

Jose

et al. 2016

Natl J Maxillofac Surg

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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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Management of parotid fistula using hypertonic saline

Cited by 16 publications

References 12 publications

Clinical and critical care concerns of cranio-facial trauma: A retrospective study in a tertiary care institute

Clinical and critical care concerns of cranio-facial trauma: A retrospective study in a tertiary care institute

Unilateral subcondylar and condylar neck fractures: Randomized clinical study

Sialocele: A rare sequlae of transparotid approach in subcondylar fracture management

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