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Palacios V, Holley A, Park A. Management of a salivary fistula following removal of mandibular distractors in a neonate. Am J Otolaryngol 2023; 44:103720. [PMID: 36493470 DOI: 10.1016/j.amjoto.2022.103720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
There are multiple management options for treatment of iatrogenic salivary fistulas including reduced oral intake, pressure dressings, total parotidectomy, tympanic neurectomy, surgical repair, radiation therapy, and pharmacotherapy. However, the optimal management of salivary fistulas is unclear due to uncertain efficacy and adverse outcomes. We present a case of a neonate that developed a submandibular fistula following removal of mandibular distractors and was ultimately successfully managed using intralesional botulinum toxin injection. The purpose of this communication is to summarize the management of this complication in the context of the current literature.
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Affiliation(s)
- Victoria Palacios
- University of Nevada, Reno School of Medicine, United States of America
| | - Anna Holley
- Division of Otolaryngology, Head and Neck Surgery and Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States of America
| | - Albert Park
- Division of Otolaryngology, Head and Neck Surgery and Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States of America.
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Truswell WH, Fox AJ. Reducing Surgical Risks in a Rhytidectomy. Facial Plast Surg Clin North Am 2023; 31:239-252. [PMID: 37001927 DOI: 10.1016/j.fsc.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Complications after rhytidectomy will occur even in the best of circumstances. Establishing a good rapport with the patient, taking a thorough history and physical exam to elicit potential risk factors such as hypertension or a bleeding diathesis, enlisting staff members to help understand a patient's goals, psychology, and supports, as well as setting realistic expectations help both the surgeon and the patient navigate the journey of surgery toward a successful outcome. Lastly, understanding how to manage potential complications when they arise, in a supportive and caring manner, is vital to the patient relationship and end result: a happy and satisfied patient.
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Mantelakis A, Spencer H, Duval JL, Joshi A. Botulinum Toxin in the Management of Hyperhidrosis and Other Salivary Conditions. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maharaj S, Mungul S, Laher A. Botulinum toxin A is an effective therapeutic tool for the management of parotid sialocele and fistula: A systematic review. Laryngoscope Investig Otolaryngol 2020; 5:37-45. [PMID: 32128429 PMCID: PMC7042652 DOI: 10.1002/lio2.350] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/26/2019] [Accepted: 01/02/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES In the management of parotid sialocele and fistula, various conservative and surgical methods have been described. Some studies have described the use of Botulinum toxin A (Botox A) for the management of parotid sialocele and fistula. This is a less invasive and potentially equally effective option. We therefore conducted a systematic review on the current body of literature relating to this specific use of Botox A. METHODS A search strategy was conducted in July 2019 using the following electronic databases: Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science. A search of all articles from inception until 31 August 2019 was performed. RESULTS Literature searches of electronic databases identified 67 articles eligible for review, of which 15 fulfilled all criteria. These studies were small and in total only 47 patients were included. The majority of sialoceles and fistulas presented as a complication of surgery (77%) with the remaining cases occurring as a result of trauma. The typical age at presentation was between 32 and 88 years of age (mean age of 52 years). All patients were initially treated with and failed other conservative measures. Botox A injection was considered as a final conservative treatment option. The toxin was administered percutaneously in all cases of parotid sialocele and fistula. Dosage of Botox ranged from 10 to 200 units with majority of patients (58%) requiring only one injection. The overall success rate for patients treated with Botox A injections ranged between 70 and 100% for parotid sialoceles and fistulas. CONCLUSION Botox A injections are successful in the treatment of parotid sialoceles and fistulas and should be considered before the use of invasive conventional options. Further studies with larger numbers are needed to ratify this recommendation. Success rate for patients, treated with Botox A injection was between 70 and 100% for parotid sialocele and fistula. Patients who failed initial treatment with Botox A were re-administered with Botox A and eventually resolved.
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Affiliation(s)
- Shivesh Maharaj
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sheetal Mungul
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Abdullah Laher
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
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Botulinum Neurotoxins and Cancer-A Review of the Literature. Toxins (Basel) 2020; 12:toxins12010032. [PMID: 31948115 PMCID: PMC7020400 DOI: 10.3390/toxins12010032] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 01/20/2023] Open
Abstract
Botulinum neurotoxins (BoNT) possess an analgesic effect through several mechanisms including an inhibition of acetylcholine release from the neuromuscular junction as well as an inhibition of specific pain transmitters and mediators. Animal studies have shown that a peripheral injection of BoNTs impairs the release of major pain transmitters such as substance P, calcitonin gene related peptide (CGRP) and glutamate from peripheral nerve endings as well as peripheral and central neurons (dorsal root ganglia and spinal cord). These effects lead to pain relief via the reduction of peripheral and central sensitization both of which reflect important mechanisms of pain chronicity. This review provides updated information about the effect of botulinum toxin injection on local pain caused by cancer, painful muscle spasms from a remote cancer, and pain at the site of cancer surgery and radiation. The data from the literature suggests that the local injection of BoNTs improves muscle spasms caused by cancerous mass lesions and alleviates the post-operative neuropathic pain at the site of surgery and radiation. It also helps repair the parotid damage (fistula, sialocele) caused by facial surgery and radiation and improves post-parotidectomy gustatory hyperhidrosis. The limited literature that suggests adding botulinum toxins to cell culture slows/halts the growth of certain cancer cells is also reviewed and discussed.
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A Functional Approach to Posttraumatic Salivary Fistula Treatment: The Use of Botulinum Toxin. J Craniofac Surg 2019; 30:871-875. [PMID: 30807467 DOI: 10.1097/scs.0000000000005293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This manuscript highlights key aspects regarding the practical use of botulinum toxin for the conservative nonsurgical treatment of a rarely encountered, but significant posttraumatic complication-the parotid salivary fistula. It adds information to the scarce existing literature on the subject. The authors outline the main differences between postoperative and trauma-related parotid injury regarding salivary fistula treatment. A total of 6 patients with trauma-related salivary fistulas have been treated by Abobotulinum toxin A injections over the course of 5 years. The technique is detailed, describing the doses used in the presence of parenchyma and duct injuries, the location and number of injection points in relation to the wound pattern. The results were favorable, leading to the healing of the salivary fistulas in all patients, with 1 injection session, without additional conservative treatment. In our experience, the use of botulinum toxin is of great benefit for treating salivary fistulas in a traumatic context.
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Gallo A, Manciocco V, Pagliuca G, Martellucci S, de Vincentiis M. Transdermal Scopolamine in the Management of Postparotidectomy Salivary Fistula. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/0145561313092010-1113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrea Gallo
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology/Head and Neck Surgery, National Cancer Institute Regina Elena, Rome
| | - Giulio Pagliuca
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
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Hills A, Kannan R, Williams M. Seldinger technique in repair of the parotid duct. Br J Oral Maxillofac Surg 2019; 57:85-87. [DOI: 10.1016/j.bjoms.2018.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/27/2018] [Indexed: 11/26/2022]
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Send T, Bertlich M, Eichhorn KW, Bootz F, Jakob M. Management and Follow-up Results of Salivary Fistulas Treated With Botulinum Toxin. Laryngoscope 2018; 129:403-408. [PMID: 30151958 DOI: 10.1002/lary.27416] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/13/2018] [Accepted: 06/06/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Salivary fistulas are a common minor complication of parotid surgery. botulinum toxin has repeatedly been reported to be an adequate treatment of this entity. To date, there is little scientific evidence for clinical decision making after appearance of a salivary fistula. STUDY DESIGN Retrospective chart analysis of 16 patients who had been treated with botulinum toxin for salivary fistula. METHODS All patients who had been treated for salivary fistula at a tertiary referral hospital from 2010 to 2016 were included. Patient files were used to obtain characteristics of patients, treatment, and follow-up. RESULTS Sixteen patients with salivary fistula received 27 injections of botulinum toxin. Nine patients required one injection for the fistula to heal, five patients needed two injections, and one patient needed three and four injections, respectively. No patient underwent additional surgery or radiotherapy. We observed no adverse effects in any patient treated with botulinum toxin. CONCLUSIONS In most cases of salivary fistula, injections of botulinum toxin are a valid treatment. If the initial injection is not successful, injections may be repeated once. Otherwise, revision surgery should be considered. In general, treatment with botulinum toxin should be commenced in an earlier stage and with higher dosages. LEVEL OF EVIDENCE 4 Laryngoscope, 129:403-408, 2019.
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Affiliation(s)
- Thorsten Send
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Mattis Bertlich
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Munich, Munich, Germany
| | - Klaus W Eichhorn
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Friedrich Bootz
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Mark Jakob
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Munich, Munich, Germany
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Zwaveling S, Steenvoorde P, da Costa SA. Treatment of Postparotidectomy Fistulae with Fibrin Glue. ACTA MEDICA (HRADEC KRÁLOVÉ) 2018. [DOI: 10.14712/18059694.2017.112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Although fistulae resulting from superficial parotidectomy represent a serious problem, there is still little consensus on the optimal treatment. Some suggest management by applying dressings, while others advise surgery. In recent years several other strategies have been proposed. In this manuscript, we present two cases of postparotidectomy fistulae treated by injection with fibrin tissue glue (Tissucol® Duo 500, Baxter AG, Vienna, Austria). Furthermore, a review of the literature is presented. In both patients the fistulae completely healed within months without complications. A literature search revealed that this is the first time postparotidectomy fistulae were treated this way. We conclude that postparotidectomy fistulae can be effectively treated with fibrin glue. Moreover, this treatment is simple, safe and has no side effects.
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Mantsopoulos K, Goncalves M, Iro H. Transdermal scopolamine for the prevention of a salivary fistula after parotidectomy. Br J Oral Maxillofac Surg 2018; 56:212-215. [PMID: 29402551 DOI: 10.1016/j.bjoms.2018.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/20/2018] [Indexed: 12/20/2022]
Abstract
Our aim was to investigate whether perioperative transdermal application of scopolamine could help to prevent fistulas after parotidectomy, and to this end we retrospectively studied the records of all patients (n=645) who had benign parotid tumours treated by partial parotidectomy between 2011 and 2016. We found that scopolamine led to a significant decrease in the incidence of salivary fistulas from 54/371(15%) in the group not given it to 10/274 (4%) in the group given it (p<0.0001). The "number needed to treat" was 9.17. There was a relatively low incidence of all adverse effects after scopolamine. Our results are encouraging. Thorough consideration of the contraindications and a knowledge of the potential adverse effects are crucial for its successful implementation.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Miguel Goncalves
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Rajeev R, Sajesh S, Jose M, Kumar ND. Sialocele: A rare sequlae of transparotid approach in subcondylar fracture management. Natl J Maxillofac Surg 2017; 7:201-204. [PMID: 28356695 PMCID: PMC5357935 DOI: 10.4103/0975-5950.201363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Iatrogenic injury and/or damage to the parotid salivary gland during transparotid approach for open reduction and internal fixation of mandibular condyle fracture is a rare event. Accumulation of saliva in the gland leads to formation of a sialocele. Huge sialocele often seeks drain through the most dependent area through an extraoral wound, whereas in the absence of extraoral fistula, saliva can be redirected intraorally using a stent. A case of mangement of sialocele caused by damage to glandular elements during a transparotid approach for a subcondylar fracture reduction is reported. The various conservative methods and surgical management for this condition are discussed.
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Affiliation(s)
- R Rajeev
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - S Sajesh
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - Mathew Jose
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
| | - N Dhineksh Kumar
- Department of Oral and Maxillofacial Surgery, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India
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Melville JC, Stackowicz DJ, Jundt JS, Shum JW. Use of Botox (OnabotulinumtoxinA) for the Treatment of Parotid Sialocele and Fistula After Extirpation of Buccal Squamous Cell Carcinoma With Immediate Reconstruction Using Microvascular Free Flap: A Report of 3 Cases. J Oral Maxillofac Surg 2016; 74:1678-86. [DOI: 10.1016/j.joms.2016.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/22/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
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Discussion: Management of the Salivary Glands and Facial Nerve in Face Transplantation. Plast Reconstr Surg 2016; 137:1898-1899. [PMID: 27219243 DOI: 10.1097/prs.0000000000002207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Ibrahim FF, Cardona I, Smith MM, Daniel SJ. Onabotulinum toxin injection for parotid fistula treatment in a case of recurrent parotitis complicated with abscess formation. Int J Pediatr Otorhinolaryngol 2015; 79:766-8. [PMID: 25819498 DOI: 10.1016/j.ijporl.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Farid F Ibrahim
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Isabel Cardona
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Mariana M Smith
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
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Laskawi R, Winterhoff J, Köhler S, Kottwitz L, Matthias C. Botulinum toxin treatment of salivary fistulas following parotidectomy: follow-up results. Oral Maxillofac Surg 2012. [PMID: 23179957 PMCID: PMC3832751 DOI: 10.1007/s10006-012-0375-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Salivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Here, we report on 12 patients with fistulas treated following parotidectomy for various indications. METHODS AND RESULTS Injection of botulinum toxin type A into the residual gland tissue was the initial treatment. After early intervention (within 6 weeks after development of the fistula), only one fistula remained (9 of 10 fistulas treated early only with botulinum toxin). One patient with early intervention did not want to wait for the botulinum toxin treatment to take effect and demanded early surgical revision, which was successful. In one patient with a permanent fistula, botulinum toxin treatment began 420 days after the operation and was unsuccessful. No side effects were evident after the treatment. CONCLUSION In summary, botulinum toxin injections into the parotid tissue remaining after surgery appear to be an effective treatment for salivary fistulas following parotidectomy.
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Affiliation(s)
- Rainer Laskawi
- Department of Otorhinolaryngology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Göttingen, Lower Saxony, Germany,
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Lazaridou M, Iliopoulos C, Antoniades K, Tilaveridis I, Dimitrakopoulos I, Lazaridis N. Salivary gland trauma: a review of diagnosis and treatment. Craniomaxillofac Trauma Reconstr 2012; 5:189-96. [PMID: 24294401 DOI: 10.1055/s-0032-1313356] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Accepted: 08/16/2011] [Indexed: 10/28/2022] Open
Abstract
Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.
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Affiliation(s)
- Maria Lazaridou
- Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
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18
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Use of 2-Octyl-Cyanoacrylate in surgical closing of Postparotidectomy salivary fistulas. Eur Arch Otorhinolaryngol 2011; 268:1691-4. [PMID: 21901336 DOI: 10.1007/s00405-011-1750-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
Abstract
A salivary fistula is one of possible postoperative complications in the surgery of parotid gland tumors. We present three cases of postparotidectomy salivary fistulas, successfully treated by surgical access using 2-octyl-cyanoacrylate while closing the skin layer. The previous treatment of these cases by other therapeutic options did not give satisfactory results. In a 5-year follow-up period there were no signs of fistulas relapses. The surgical access with use of 2-octyl cyanoacrylate can be one of therapeutic options for the closing of postparotidectomy salivary fistulas, especially in cases where other therapeutic accesses are not successful.
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Sujeeth S, Dindawar S. Parotid duct repair using an epidural catheter. Int J Oral Maxillofac Surg 2011; 40:747-8. [DOI: 10.1016/j.ijom.2011.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 02/03/2011] [Indexed: 10/18/2022]
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20
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Wang SJ, Eisele DW. Parotidectomy-Anatomical considerations. Clin Anat 2011; 25:12-8. [DOI: 10.1002/ca.21209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Revised: 04/08/2011] [Accepted: 05/01/2011] [Indexed: 11/07/2022]
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21
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Wittekindt C, Burmeister H, Guntinas-Lichius O. Diagnostik und Therapie von Speicheldrüsenerkrankungen. DER PATHOLOGE 2009; 30:424-31. [DOI: 10.1007/s00292-009-1202-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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KRISHNAN RAVIS, CLARK DAVIDP, DONNELLY HEIDIB. The Use of Botulinum Toxin in the Treatment of a Parotid Duct Injury During Mohs Surgery and Review of Management Options. Dermatol Surg 2009; 35:941-7. [DOI: 10.1111/j.1524-4725.2009.01159.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Iatrogenic Parotid Sialocele After Excision of Malignant Melanoma of the Cheek. Dermatol Surg 2008. [DOI: 10.1097/00042728-200811000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Bomeli SR, Desai SC, Johnson JT, Walvekar RR. Management of salivary flow in head and neck cancer patients – A systematic review. Oral Oncol 2008; 44:1000-8. [DOI: 10.1016/j.oraloncology.2008.02.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 02/14/2008] [Accepted: 02/15/2008] [Indexed: 11/29/2022]
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25
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Abramova L, Mann M, Hessler J, Sengelmann RD. Iatrogenic parotid sialocele after excision of malignant melanoma of the cheek. Dermatol Surg 2008; 34:1584-8. [PMID: 18798743 DOI: 10.1111/j.1524-4725.2008.34329.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Liana Abramova
- Department of Internal Medicine, Division of Dermatology, Washington University School of Medicine, St Louis, MO 63110, USA.
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26
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27
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Hatzis GP, Finn R. Using botox to treat a mohs defect repair complicated by a parotid fistula. J Oral Maxillofac Surg 2007; 65:2357-60. [PMID: 17954340 DOI: 10.1016/j.joms.2006.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Revised: 07/28/2006] [Accepted: 10/05/2006] [Indexed: 10/22/2022]
Affiliation(s)
- Gregory P Hatzis
- Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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28
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Doctor VS, Rafii A, Enepekides DJ, Tollefson TT. Intraoral Transposition of Traumatic Parotid Duct Fistula. ARCHIVES OF FACIAL PLASTIC SURGERY 2007; 9:44-7. [PMID: 17224488 DOI: 10.1001/archfaci.9.1.44] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
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.
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Affiliation(s)
- Vishal S Doctor
- Department of Otolaryngology -- Head and Neck Surgery, University of California, Davis Medical Center, Sacramento, CA 95817, USA
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Ozcan C, Vayisoglu Y, Doğu O, Görür K. The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis. Am J Otolaryngol 2006; 27:314-8. [PMID: 16935174 DOI: 10.1016/j.amjoto.2006.01.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Indexed: 11/30/2022]
Abstract
PURPOSE Vasomotor rhinitis (VMR) is a common disease that is unrelated to allergy, infection, structural abnormalities, and systemic diseases. Patients with VMR usually complain of nasal obstruction accompanied by profuse watery nasal discharge. The exact pathophysiologic mechanisms of VMR are not known. Some studies suggested that it results from an autonomic nervous system dysfunction. No effective long-term treatment modalities exist for the VMR. MATERIALS AND METHODS Thirty patients with VMR were randomly and equally divided into 2 groups. The mean age was 38.46 years (range, 18-59 years; 1 men, 14 women) for group 1 and 41.60 (range, 29-62 years; 4 men, 11 women) for group 2. Five patients with VMR were accepted as a control group. Fifteen patients were injected 10 U of botulinum toxin A (BTX-A) (group 1) and patients in group 2 were injected 20 U to inferior and middle turbinates. Control patients were injected with saline solution into the inferior and middle turbinates. RESULTS Total symptom scores generally decreased after the first week and increased after the eighth week. The symptoms of patients (nasal obstruction, sneezing, nasal discharge, and nasal itching) were scored from 1 to 5, with 1 as less severe and 5 as most severe. The statistical significance of the results was analyzed using Kruskal-Wallis and Mann-Whitney U test. When total symptom scores of group 1 (10 U BTX-A) were compared with the control group, there was a statistically significant difference regarding symptoms scores at all control weeks. There was also a statistically significant difference for total symptom scores between group 2 and control group, except for the first control week. CONCLUSION Intranasal injection of BTX-A is a highly effective, safe, and simple symptomatic treatment modality with a long-lasting effect for patients with VMR. Botulinum toxin A may be a good alternative especially for the treatment of resistant VMR cases.
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Affiliation(s)
- Cengiz Ozcan
- Department of Otorhinolaryngology, School of Medicine, Mersin University, Mersin, Turkey.
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Abstract
In recent years, a number of potential new therapeutic indications of botulinum toxin injections have emerged, amongst which sialorrhea has attracted considerable attention. Based on open-label and controlled studies, botulinum toxin can be used to improve sialorrhea in patients with Parkinson's disease, parkinsonian syndromes, motor neuron disease and cerebral palsy. The toxin can be injected blindly based on anatomic landmarks of the salivary glands, or localization can be facilitated by use of ultrasound guidance. There are few reported adverse effects. However, many more carefully designed, controlled studies are still required to address the specific questions related to selection of patients, the optimal injection technique, the appropriate dose of botulinum toxin and its long-term effects.
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Affiliation(s)
- E-K Tan
- Department of Neurology, Singapore General Hospital, National Neuroscience Institute, Division of Research, SingHealth.
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31
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Breuer T, Ferrazzini A, Grossenbacher R. Botulinumtoxin A zur Therapie traumatischer Speichelfisteln. HNO 2006; 54:385-90, 392-3. [PMID: 16078054 DOI: 10.1007/s00106-005-1311-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Injury of salivary gland tissue in the head and neck, as the result of extensive trauma, can often be overlooked on initial examination. In two case reports, the primary treatment and further follow-up of injuries of the head resulting in a parotid-maxillary sinus fistula as well as a fistula between the skin and sublingual gland are illustrated. The successful use of botulinum toxin in the treatment of traumatic salivary gland fistulas is documented in both cases. Alternative diagnostic and treatment measures of salivary gland fistulas are discussed. Surgical repair of salivary fistulas as primary treatment should be carefully considered. Treatment of a salivary fistula with the injection of botulinum toxin is possibly advantageous compared to spontaneous fistula closure. The injection of botulinum toxin shortens fistula closure time, is minimally invasive, effective and tolerable for the patient.
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Affiliation(s)
- T Breuer
- HNO-Klinik, Hals- und Gesichtschirurgie, Kantonsspital St. Gallen.
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Marchese-Ragona R, Marioni G, Restivo DA, Staffieri A. The role of botulinum toxin in postparotidectomy fistula treatment. A technical note. Am J Otolaryngol 2006; 27:221-4. [PMID: 16647991 DOI: 10.1016/j.amjoto.2005.09.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE Parotid fistula is a well-known complication of parotidectomy or penetrating injury of the parotid gland. The management of parotid fistula has been controversial, and numerous conservative and surgical treatment methods have been described. METHODS We report 3 cases of parotid fistula after partial parotidectomy, which were treated by botulinum toxin injection under electromyographic control into the residual substance of parotid gland. RESULTS Complete healing of the fistula was achieved with a single botulinum toxin treatment in all patients. No side effects were observed after the treatment. The patients are disease-free after 21, 18, and 14 months, respectively. CONCLUSIONS In the considered cases, the localized injection of botulinum toxin into the parotid gland resulted to an effective and long-lasting treatment of postparotidectomy fistula.
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Wollina U, Konrad H, Petersen S. Botulinum toxin in dermatology - beyond wrinkles and sweat. J Cosmet Dermatol 2005; 4:223-7. [PMID: 17168867 DOI: 10.1111/j.1473-2165.2005.00195.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Botulinum toxin (BTX) types A and B have been used with success in cosmetic dermatology and hyperhidrosis treatment. The present review focuses on other uses of BTX in dermatology. Discussed in particular are the available data on BTX in inflammatory diseases, proctology, and some other indications. From studies in various types of eczema, it seems that BTX-A not only acts as a potent inhibitor of acetylcholine but also as an inhibitor of substance P and of glutamate as well. By those mechanisms, BTX-A may be antipruritic, which may help explain the benefits of BTX-A in lichen simplex and dyshidrotic hand eczema. In Hailey-Hailey disease, facial eccrine hidrocystomas, salivary fistulas, and intrinsic rhinitis, BTX-A blocks the secretion of sweat/saliva/mucus. BTX-A has important applications in proctology where it has become the most powerful nonsurgical therapy for anal fissures. In proctalgia fugax and after hemorrhoidectomy, BTX-A is analgesic. Current treatment applications of BTX-A and its limitations are reviewed in this paper.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
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Abstract
Injuries to the buccal region of the face can carry multiple complications due to the complex anatomy that lies within. The facial nerve and the parotid duct can be easily injured by sharp or penetrating trauma to the cheek. The purpose of this paper is to present the full spectrum of current treatment modalities available to manage these injuries. The anatomy of the parotid gland and duct are described, and surgical techniques and therapeutic alternatives for the immediate and delayed treatment of the parotid duct injuries are reviewed. Clinical cases are presented to illustrate the treatment options outlined.
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Affiliation(s)
- Mark J Steinberg
- Division of Oral and Maxillofacial Surgery and Dental Medicine, Loyola University Medical Center, Maywood, IL 60153, USA.
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35
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Nolte D, Gollmitzer I, Loeffelbein DJ, Hölzle F, Wolff KD. Botulinumtoxin zur Behandlung des gustatorischen Schwitzens. ACTA ACUST UNITED AC 2004; 8:369-75. [PMID: 15517441 DOI: 10.1007/s10006-004-0575-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Botulinum toxin A has meanwhile become a proven method for treatment of gustatory sweating (focal hyperhidrosis, Frey's syndrome). Clear-cut recommendations regarding dosage of botulinum toxin A in Frey's syndrome are currently not available. The aim of this prospective randomized study therefore was to investigate botulinum toxin A with respect to its efficacy in Frey's syndrome, the ideal dose yielding maximal duration of the effect, and patient contentedness as well as unwanted side effects in patients of the Clinic of OMF Surgery at the Ruhr-University of Bochum. PATIENTS AND METHOD Twenty patients suffering from severe Frey's syndrome as a result of operations of the parotid gland were examined with the starch iodine test according to Minor. The gustatory skin areas were re-examined after intracutaneous injection of botulinum toxin A for up to 1 year. The patients ( n=20) were randomly assigned to two different treatment groups (group I: 2 MU/cm(2), n=10; group II: 3 MU/cm(2), n=10). RESULTS Mean sweating skin areas in the two treatment groups ranged between 39+/-9 and 32+/-12 cm(2), respectively. A single injection of 3 MU botulinum toxin A resulted in a nearly complete blockade of gustatory sweating for the observation period of 1 year. In the group treated with 2 MU botulinum toxin A, 44% of the total gustatory skin areas were still sweating, thus necessitating a second injection of botulinum toxin A in these patients. CONCLUSION Intracutaneous injection of botulinum toxin A represents a highly effective and minimally invasive procedure for the treatment of Frey's syndrome. This study shows for the first time that a dosage of 3 MU/cm(2) of botulinum toxin A achieves a complete and reliable blockade of gustatory sweating lasting for at least 12 months. This dose may therefore be recommended for treatment of this syndrome.
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Affiliation(s)
- D Nolte
- Klinik für Mund-, Kiefer- und Plastische Gesichtschirurgie, Knappschaftskrankenhaus Bochum-Langendreer Ruhr-Universität Bochum.
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Abstract
In conclusion, botulinum toxin usage over the past 2 to 3 decades has expanded exponentially. Almost every discipline in medicine has found some therapeutic use for this toxin. Botulinum toxin has been shown to be safe, effective, and relatively easy to administer with proper training.
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Affiliation(s)
- Craig Zalvan
- Department of Otolaryngology, New York Medical College, 1055 Saw Mill River Road, Ardsley, NY 10502, USA
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Abstract
Since the introduction of botulinum toxin (BTX) as a therapeutic tool in the 1970s, the number of uses for this substance has increased exponentially. BTX's mechanism of action involves degrading the SNARE proteins blockading the release of acetylcholine into the neuromuscular junction. In many body systems, decrease of contractility, strength, and tension of certain muscle groups result in improved clinical outcomes. Applications now include cosmetic, gastroenterologic, otolaryngologic, genitourinary, neurologic, and dermatologic uses. In fact, BTX can be considered as a potential treatment in any situation involving inappropriate or exaggerated muscle contraction. Currently, the FDA has approved BTX-A (Botox) for treating glabellar lines, blepharospasm, strabismus, hemifacial spasm, cervical dystonia, and spasticity. With the addition of cosmetic applications to the FDA's approval list, the use of BTX has increased dramatically.
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Affiliation(s)
- Boris Bentsianov
- New York Center for Voice and Swallowing Disorders, New York, NY 10019, USA
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Guntinas-Lichius O. Management of Frey's syndrome and hypersialorrhea with botulinum toxin. Facial Plast Surg Clin North Am 2003; 11:503-13. [PMID: 15062255 DOI: 10.1016/s1064-7406(03)00075-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Botulinum toxin (BTX) is a safe and reliable drug for the treatment of Frey's syndrome and hypersialorrhea. Currently, the intradermal injection of BTX is the standard treatment of Frey's syndrome. A disappearance of Frey's syndrome for 1 to 1.5 year could almost be promised. Recently, BTX was introduced for the treatment of hypersialorrhea. Although some questions exist about the optimal dosage and the type of major salivary glands that should be treated, hypersialorrhea was reduced in almost all affected children and adults for up to 6 months by using ultrasound-guided intraglandular BTX injections.
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Affiliation(s)
- Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, D-50924 Cologne, Germany.
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