A Simple Technique for Treatment of Post Traumatic Sialocele of Parotid Gland

Sialocele refers to extra parotid collection of salivary secretions in peri-parotid soft tissue space. Sialocele is seen more commonly after superficial parotidectomy or penetrating injury to face. However incidence of post traumatic sialocele after blunt injury to face is very rare and it is sparsely reported in literature [1]. Most common clinical presentation is presence of soft, cystic swelling in the region of cheek, which recurs even after repeated aspirations. Traditionally USG and CT scan of face with digital sialograhy were used in evaluation such parotid area lesions. Imaging usually reveals fluid filled cystic swelling in relation to parotid duct. To assess the status of duct, traditionally digital sialography was done after injecting dye into the duct via parotid orifice. Currently MR sialography is replacing digital sialography as it is non-invasive, it precisely localizes the site of ductal injury, provides status of proximal duct upto second order branches [2,3]. Available treatment options for sialocele include repeated aspiration with pressure bandage, tympanic neurectomy, botox injection over parotid gland and anti-sialogogues [4]. Most of these options are used for treatment of sialocele that develops over parotid gland. When sialocele occurs along the course of parotid duct, it is usually due to ductal injury. Most commonly due to laceration injury to face [5] or as a complication of surgical procedures like maxillo facial fracture repair [1], rhytidectomy procedure etc. In such cases, treatment involves surgical repair of ductal injury after localising the site of involvement. Also therapeutic challenges happen when there is diagnostic delay or delay in initiation of treatment, failure of response to treatment, secondary infection or fistula formation. When addressing ductal injury, stenting of duct is essential to prevent restenosis. Ductal dilatation and stenting can be done either intra-orally or via open approach depending upon site of involvement. Sialendoscope when available can be used to localize the site of leak, placement of stent, to confirm ductal patency after repair of ductal injury [6]. Here we present a case of post traumatic sialocele, secondary to blunt injury over face treated in a novel way using salivary endoscopy at our tertiary care institution. Abstract