Salivary fistula

Introduction : Because of trauma or surgical injury, the sputum excretion caused by parotid gland or parotid duct is called sputum. The clinical manifestation is that there is a small mouthwash on the facial skin, and there is clear sputum outflow. The main cause of this disease is injury, which occurs mostly in the parotid gland and its ductal part. The surgical treatment method has a high cure rate. Debridement and suture after injury in the parotid gland is the key to prevent this disease. A point-like fistula can be seen on the skin corresponding to the gland or catheter site; the transparent liquid flows out and increases when eating.

Cause

Because of trauma or surgical injury, the sputum excretion caused by the parotid gland or parotid duct is called sputum. The clinical manifestation is that there is a small mouthwash on the facial skin, and there is clear sputum outflow. The main cause of this disease is injury, which occurs mostly in the parotid gland and its duct.

1. There has been a history of severe contusion and trauma in the parotid area.

2. The depth of the parotid area or the cheek is deep in the history of cutting the knife.

3. Buccal, parotid, and temporomandibular joint surgery can damage the catheter and cause spasm.

an examination

Related inspection

Blood routine parotid ultrasound

Auxiliary inspection

1. Effluent liquid for biochemical qualitative analysis, containing amylase.

2. Parotid gland angiography: Contrast can be injected from the mouth or fistula of the parotid gland. When the parotid gland is adenoid, the contrast agent overflows somewhere in the gland, and the catheter shows good; the catheter sputum shows that there is contrast agent spillover at the fistula on the main catheter.

3. Inject 1% methylene blue from the mouth of the parotid gland and carefully observe the injury site.

Differential diagnosis

Identify the mouth caused by other causes

The glandular gland of the parotid gland should be distinguished from the first cleft palate when it is between the earlobe and the mandibular angle. The latter is a congenital cleft palate with a long history and a sebum-like or okara-like substance. Lean pus, but less secretion, has nothing to do with eating, patients have no history of surgery or trauma in the area.

1. History of trauma or surgery.

2. The skin of the face is small, the drip is out, and it is related to eating.

3. Injecting methylene blue into the catheter can overflow from the fistula.

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