ステノン管断裂の一治験例

Abstract

An accidental blow with a piece of iron caused a crushing injury of the left cheek of a 52-year-old woman. The patient had emergency surgery at a nearby hospital. Starting the next day there was bulging of the left cheek after eating. Since pressure bandaging for 10 days did not reduce the swelling, she was referred to our hospital. A 70mm wound was present along the midline of the left cheek. No salivary flow was seen from the ostium of Stenon's duct. Facial paralysis was not present. A sialogram and sialo-CT scan demonstrated obstruction of Stenon's duct and a sialocele. Under general anesthesia reoperation was performed. It was found that the distal end of the severed Stenon's duct had been ligated with silk and a sialocele had formed in the superficial part of the parotid gland. A silicone tube was introducted through the duct, and an end-to-end anastomosis of Stenon's duct was accomplished. The ruptured parotid gland was closed with silk sutures. On the 10th day the tube was removed, and salivary flow could be observed. A sialogram on the 14th day demonstrated slight constriction of the anastomosis. 99mTc scintigraphy indicated functional recovery of the left parotid gland 3 months after the operation.