Traumatic Lesions of the Salivary Glands

Inflammatory and Obstructive Disorders of Salivary Glands

Obstructive and inflammatory diseases of the salivary glands can have a congenital, traumatic, metabolic, or infectious-inflammatory cause. The acute inflammatory conditions include bacterial and viral infections, and the chronic conditions include sialoliths, strictures, chronic sialadenitis, sialectasis, and lymphoepithelial disease. The neoplastic diseases can cause obstruction and/or infection and often make the diagnosis elusive. In addition to a working knowledge of possible etiology, one needs experience with clinical examination, salivary analysis, sialography, CT scans, MRI, and fine-needle aspiration and cytology in order successfully to evaluate and manage patients with these conditions.

Intraoral Transposition of Traumatic Parotid Duct Fistula

Parotid duct fistula is uncommon but difficult-to-treat complication that often results from a penetrating trauma. While there is general consensus in the literature as to the management of acute parotid injuries, treatment of chronic fistulas remains controversial. We review the current treatment options for parotid duct fistulas and describe an intraoral diversion technique to reestablish salivary flow in the setting of a nonfunctional parotid duct punctum.

Trauma to the salivary glands

Penetrating and blunt trauma to the salivary glands produces potential injury to the salivary tissue, salivary ducts, and to the facial nerve. This article presents a rationale of management for glandular and duct injury, emphasizing surgical and conservative therapy. It also presents management of neural injury including a discussion of surgical options and conservative management with electrical testing.

An unusual parotid foreign body presenting as recurrent trismus

A case is reported of a foreign body in the left parotid gland, which presented in an unusual manner following a trivial injury and posed a difficult diagnostic problem, trismus being the most prominent clinical feature. The importance of having a high index of suspicion for retained foreign bodies is stressed.

Inflammatory and obstructive disorders of salivary glands

Obstructive and inflammatory diseases of the salivary glands can have a congenital, traumatic, metabolic, or infectious-inflammatory cause. The acute inflammatory conditions include bacterial and viral infections, and the chronic conditions include sialoliths, strictures, chronic sialadenitis, sialectasis, and lymphoepithelial disease. The neoplastic disease can cause obstruction and/or infection and often make the diagnosis elusive. In addition to a working knowledge of possible etiology, one needs experience with clinical examination, salivary analysis, sialography, CT scans, MRI, and fine-needle aspiration and cytology in order successfully to evaluate and manage patients with these conditions.

Traumatic injuries in the parotid region

The facial nerve, parotid duct, and external ear canal are at risk from penetrating injuries in the parotid region. The areas of the face supplied by the major branches of the facial nerve should be checked in the emergency department so that repair of a cut nerve can be performed while the distal end is able to be stimulated electronically. The parotid duct can be probed and lacerations repaired. The external ear canal should be repaired and stented to prevent stenosis.