Abstract
BackgroundSalivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Here, we report on 12 patients with fistulas treated following parotidectomy for various indications.Methods and resultsInjection of botulinum toxin type A into the residual gland tissue was the initial treatment. After early intervention (within 6 weeks after development of the fistula), only one fistula remained (9 of 10 fistulas treated early only with botulinum toxin). One patient with early intervention did not want to wait for the botulinum toxin treatment to take effect and demanded early surgical revision, which was successful. In one patient with a permanent fistula, botulinum toxin treatment began 420 days after the operation and was unsuccessful. No side effects were evident after the treatment.ConclusionIn summary, botulinum toxin injections into the parotid tissue remaining after surgery appear to be an effective treatment for salivary fistulas following parotidectomy.
Highlights
Salivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases
Salivary fistulas can occur after parotid gland surgery [1, 5, 7, 8, 11, 14, 15]
There is no clear definition in the literature of when a salivary fistula subsequent to parotid surgery should be classified as “permanent”
Summary
Salivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Salivary fistulas can occur after parotid gland surgery [1, 5, 7, 8, 11, 14, 15] This occurs in 4 % of the cases in our clinic [8], but incidence rates of up to 14 % have been reported [11, 12]. Kottwitz : Permanent fistulas (see example in Fig. 1) that persist after complete wound healing after the parotid gland procedure are a subgroup that requires special attention. They are difficult to treat [1, 6, 16], and preventive measures should be initiated early on
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