Introduction: The aetiology of parotid duct injuries is thought to be frequently caused by penetrating injuries in the parotid region, blunt trauma, complication of parotid duct cannulation for sialography and intra-operative iatrogenic injuries (tumour resection.) Approximately 0.2% of patients presenting with a penetrating injury to the parotid region experience injury to the parotid duct.
We would like to present our limited case series and experience from Royal London Hospital, a trauma centre in London.
Objectives: Comprehensive literature review to ascertain current thinking of management parotid duct injuries and management of their sequelae.
Case reports: 4 cases were the result of penetrating injury, 1 following buccal mucosa tumor resection. All were treated aggressively within 24 h. For the penetrating injuries, a lacrimal probe was used to cannulate the parotid duct and the use of paediatric arterial cannula was used as a stent to suture the duct ends. For the oncological patient a false tract was made and corrugated drain was inserted. All stents and drains were kept in for at least 3 weeks. 1 out of 4 patients with penetrating injuries went back to theatre for reanastomosis 4 weeks later due to persistent sialocele formation. All 5 patients had no long term functional problems. All cases are presented with photos as well as radiological imaging.
Conclusion: There are 2 schools of thought in the management of duct injuries. The authors advocate early intervention in order to avoid a long recovery period. Current guidelines and rationale for these are discussed.
Conflict of interest: None declared.