Management of Parotid Leakage Following Rhytidectomy

Abstract

Six patients with parotid pseudocysts following face lifts are reported. Insertion of a suction drain in three patients provided earlier resolution than repeated aspiration in the other three.

An Unusual Complication Following Rhytidectomy: Iatrogenic Parotid Injury Resulting in Parotid Fistula/Sialocele

“…4,25 In the literature, traumatic injuries present in largely a similar manner and can often be more easily diagnosed based on the site of injury and open wounds. Swelling and serous drainage from the wound (leaking salivary fluid) are generally the presenting symptoms.…”

“…Simple aspiration or sampling of a fluid collection may be sent for amylase testing, as described in one of our case reports. [3][4][5]14,25,26 A high amylase exceeding 10 000 U/L is diagnostic. 14 Surgical exploration may be used to identify parenchymal or ductal injury.…”

“…Aspiration (isolated or serial) and drainage strategies (operative with placement of drain) have been commonly employed in these situations. [2][3][4][5]20,[24][25][26] This is often combined with compression therapy. A bland diet has been used as an adjunct to therapy.…”

“…[2][3][4][5] Parotid injury is a known occurrence after parotid surgery/ parotidectomy, 6-10 trauma, 6,[10][11][12][13][14][15][16] and other surgical procedures to the face, 6,[17][18][19] but this complication after rhytidectomy is rare. There are only 12 previously documented reports in the literature, covering 20 total cases [2][3][4][5][20][21][22][23][24][25][26][27] (Table 1).…”

“…Parotid injury could cause difficulties with skin flap healing, underlying tissue injury, persistent swelling, significant distress for the patient, and an aesthetically displeasing result. 5,21,25 Despite there being a relative abundance of literature on traumatic parotid injury, there is a relative paucity of information on iatrogenic parotid injury after rhytidectomy. Additionally, there is no consensus on management of these complications.…”