Botulinum toxin a therapy for post-traumatic parotid sialocele – A case report and review of the literature

Abstract

Parotid sialocele is a collection of saliva in the subcutaneous tissue around the gland or duct 1. This may result from trauma or as a complication of surgery to the parotid area 2.We hereby present a case of parotid sialocele which developed in a patient who sustained penetrating trauma to the parotid area during a motor vehicle accident. The patient was assessed as having a post-traumatic parotid sialocele with complete transection of the parotid duct, and was managed primarily with serial aspirations, compression dressings and anticholinergic medication for seven days.Persistent sialocele after one week of treatment incited the use of Botox A as therapeutic alternative to surgery. The sialocele was aspirated by means of a sterile technique and this saliva was used to reconstitute Botox A. 30 Units of Botox A was then percutaneously injected in a sterile method, into the residual sialocele as a single injection, using a 25-gauge tuberculin syringe. Saliva was used to reconstitute the Botox as in our opinion, it is the most physiological fluid medium for dilution of Botox.