Postoperative sialadenitis following retromastoid suboccipital craniectomy for posterior fossa tumor

Abstract

During retromastoid and far-lateral posterior fossa surgical approaches the head may be positioned at the extreme limits of rotation and extension. In rare instances, patients may develop acute sialadenitis after surgery as a consequence of such positioning. In those patients, the neck/facial swelling is contralateral to the craniectomy site. The mechanism implicated in acute sialadenitis in the patient described in this report was because of obstruction to the salivary duct due to surgical positioning. The course of this complication is typically benign if it is identified early in the postoperative period.

Acute unilateral post-operative submandibular sialadenitis following posterior cranial fossa surgery

“…As posterior fossa surgeries such as retrosigmoid and far-lateral approach require extreme head rotation and flexion for long duration, this complication has been most commonly seen during these procedures. [2457] The swelling occurs on the side opposite to that of the surgery. Although the exact reason is not known, various mechanisms have been proposed as a reason for this complication.…”

“…[12] It develops on the side opposite to the surgery and can lead to respiratory compromise. [345] Here, we report a case of retrosigmoid craniotomy developing acute respiratory distress in post-operative period due to acute submandibular gland sialadenitis.…”

Postoperative Acute Submandibular Sialadenitis after Neurosurgery: Two Case Reports and a Review of the Literature

“…Progression of submandibular swelling is so rapid that emergent re-intubation is required in most cases. 1) The swelling of the soft tissue may sometimes cause brachial plexopathy. 2,3) Nevertheless, acute submandibular sialadenitis basically has a good prognosis with conservative treatment, if early airway protection is performed; therefore, awareness of this complication at its beginning is crucial.…”

“…According to the literature written in English (Table 1), 1–3,5–8) the affected age of patients who showed unilateral submandibular sialadenitis ranged from 20 years to 73 years old. Surgical positions adopted and the operation time also varied in these cases.…”

“…1,6,11) Compression of these tissues by the endotracheal tube may cause their temporary ischemia. Head rotation may also cause a compression of the facial artery itself, which supplies the submandibular gland and could lead to ischemia.…”