The ectopic accessory parotid system with congenital cheek fistula: An overview and current update

Abstract

The EAPS is a rare craniofacial anomaly presenting with a saliva-draining cheek fistula, associated with ipsilateral preauricular appendages (microtia) and occasional mandibular hypoplasia. Speculative developmental theories suggest dysmorphogenesis of the first two pharyngeal arches, clinically and embryologically relating it with OAVS. This review summarizes the clinical aspects, and establishes isolated EAPS as a mild but discrete phenotype of OAVS irrespective of the presence of other congenital stigmata. Laryngoscope, 127:1351-1360, 2017.

Unusual Conditions Impairing Saliva Secretion: Developmental Anomalies of Salivary Glands

“…Heterotopic salivary gland tissue consists in salivary tissue with an independent ductal system located in an unusual anatomical site, isolated from the main SG, and clinically presenting as a saliva-draining skin fistula (Cannon et al, 2012). The external opening can be located in oral mucosa, retroauricular region, buccal, or cervical region (Dutta, 2017). Less extensive surgery is usually required for HSGT because the associated tract, if present, is usually short in contrast to branchial cleft anomalies, which may exist as complete fistulas (Cannon et al, 2012).…”

Ultrasound Evaluation of Dermal Sinuses/Fistulas in Pediatric Patients

“…A cheek fistula is a rare anomaly . Although the incidence of this anomaly is unclear, fistulas usually open at the cheek (Figure ).…”

“…If the distal side is not clearly detected, other modalities, including CT and MRI, might be useful to evaluate the connection with the salivary gland . Surgical resection is the mainstay of treatment of this fistula …”

“…As radiology is a discipline that encompasses numerous specialties; radiologists and sonographers often examine children with various diseases referred by different departments. Thus, it is important for radiologists to be familiar with the condition of a dermal sinus to be able to direct any further diagnostic imaging modality and facilitate diagnostic treatment of the condition via the appropriate specialist …”

“…In addition, color Doppler US without contrast enhancement is useful to differentiate a fistula from a vascular lumen . Determining the extent of the sinus's distal side is important for complete resection to prevent recurrence; US allows an accurate evaluation of the distal side …”