Use of hypertonic saline in the management of parotid fistulae and sialocele: a report of 2 cases

Abstract

Parotid fistula is a well known complication of parotidectomy or penetrating injury of the parotid gland. Fistulae may be internal or external, but simple internal fistulae are of no surgical interest. In cases of external fistulae, the principles of management aim at the return of normal parotid function in both acute and chronic parotid injury, but sometimes the alternative is to depress parotid secretions to allow natural healing process to seal the injury. The paper highlights the indications, techniques, advantages and disadvantages of using osmotic sclerosant for the management of parotid fistulae. We used warm hypertonic saline injections within the glandular substance to cause rapid fibrosis of the gland in 2 patients of chronic parotid fistulae. This technique is a simple and effective method of dealing with salivary leak. Its ease of performance, effectiveness; minimal surgical risk and minor cost are the advantages over other available options.

Management of parotid fistula using hypertonic saline

“…The temperature of the saline can be raised above body temperature (60 degree) to enhance the fibrosing property of physiologic saline. [ 17 ]…”

Management of an unusual case of iatrogenic parotid sialocele using an infant feeding tube: a novel approach

“…Diagnosis can be made by fine needle aspiration cytology, sialography, contrast CT and MRI. The various treatment options recommended include repeated aspirations and compression dressings, antisialogogues, parasympathetic denervation (tympanic neurectomy), percutaneous sclerotherapy, sialography, sialendoscopy, botulinum toxin7 and injection of hypertonic saline into the gland 8…”