Microsurgical Repair of Stensen's Duct Using an Interposition Vein Graft

Abstract

Facial wounds are frequently associated with bone fractures and multiple trauma; however, disruption of the parotid gland or Stensen's duct is rare and is often associated with facial nerve palsy. Lesions are often undiagnosed on first assessment of the multiple trauma patient. If microsurgical repair of Stensen's duct provides good functional results, ignoring such lesions often leads to later complications such as fistulae and sialocoeles. Although simple ligation of Stensen's duct has been reported to give satisfactory results, the authors prefer a more anatomic reconstruction of this structure whenever possible. A case of Stensen's duct microsurgical repair using a vein graft are reported.

Stensen Duct Relocation After Cheek Mucosa Tumor Resection

“…It comes out into the vestibule of the mouth next to the maxillary second molar tooth (17 and 27), where its papilla is located. 4 After cheek mucosa tumor resection and free flap reconstruction, Stensen duct preservation and relocation are mandatory to preserve salivary function. If the duct is transected without repair, subsequent stricture, cheek swelling, fistulas, and obstructive sialadenitis may occur.…”

“…There are several reports on the management of the parotid duct injuries, 7,8 suggesting microsurgical anastomoses, autologous vein grafting, and mucosal flaps to repair duct damages. 3,4 Nevertheless, no data on how to relocate the parotid duct in the oral cavity after tumor resection are available.…”

“…2,3 The frontal sinus is a strategic structure that is located between the anterior cranial fossa and the naso-orbitoethmoid region. 4 These paired pneumatized cavities are located in the frontal bone. Each sinus is bordered by anterior and posterior walls.…”

Therapie nichttumoröser Speicheldrüsenerkrankungen und postoperativer Komplikationen

“…Tag) zu entfernen [134]. Liegt infolge eines schweren Traumas ein Substanzverlust vor, so kann der Defekt durch ein Veneninterponat überbrückt werden [100].…”

Intraoral Transposition of Traumatic Parotid Duct Fistula

“…In these cases, 3 alternatives have been suggested: (1) ligation of the proximal duct to induce atrophy of the gland 5 ; (2) diversion of the proximal segment into the oral cavity 6 ; and (3) microsurgical repair of the parotid duct with an autologous interposition vein graft. 7 Delayed treatment of parotid duct injuries is more controversial. Failure to diagnose or treat duct injury soon after it occurs often results in sialocele or fistula formation.…”