Management of Sialoceles Using an Indigenous Salivary Stent

Background

A Sialocele is a subcutaneous extravasation of saliva from the salivary gland secondary to traumatic disruption of its duct or parenchyma. It is observed after ablative head and neck surgery or due to trauma. Though there are several techniques described, there is no universal consensus on how to treat postoperative sialoceles.

Purpose

This paper describes a simple technique which was used to successfully treat 11 patients with postoperative sialoceles.

Methods

In this paper we have described the use of an indigenously designed tapered stent used to decompress the sialocele. The decompression allows natural healing and fibrosis to occur over 4-6 days thereby resolving the sialocele.

Results

11 patients with postoperative sialoceles were successfully treated using our technique.

Conclusion

The technique described by the authors is a simple, easy to perform procedure that can be managed in the outpatient office under local anesthesia with minimal equipment.

Baseline findings of a multicentric ambispective cohort study (2021-2022) among hospitalised mucormycosis patients in India

In India, the incidence of mucormycosis reached high levels during 2021-2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March-July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease's clinical progression and help frame standard treatment guidelines.