Difference between revisions of "Salivary Fistula"

From WikiVet English
Jump to navigation Jump to search
 
(3 intermediate revisions by 2 users not shown)
Line 1: Line 1:
== Description ==
+
{{OpenPagesTop}}
 +
== Introduction ==
  
A salivary fistula can result from injury to any salivary gland, but most commonly the parotid. Fistulas forming from other glands is uncommon. 
+
A salivary fistula can result from injury to any salivary gland, but most commonly the [[Parotid Gland - Anatomy & Physiology|parotid]]. Fistulas forming from other glands is uncommon. Damage may be due to traumatic wound to the face e.g. bite wound or abscess drainage. Exopthalmus is the most likely cause of zygomatic fistula. The continuous flow of saliva due to trauma to the face prevents healing and therefore a fistula develops. Discharge from the gland may be noticeably worse before or during feeding.
 
 
Injury may be due to traumatic wound to the face e.g. bite wound or abscess drainage. Exopthalmus is the most likely cause of a zygomatic fistula.
 
 
 
The continuous flow of saliva prevents healing and therefore a fistula develops  
 
 
 
When a salivary duct injury occurs due to trauma on the face, this results in a fistula being created which will cause discharge of saliva onto the face. Discharge from the gland may be noticably worse before or during feeding.<br><br>
 
  
 
== Diagnosis  ==
 
== Diagnosis  ==
  
=== Clinical Signs  ===
+
Diagnosis is largely made from clinical signs and history.
  
*Fistula visible over parotid region, or located upon clinical examination  
+
The fistula is often visible over the parotid region, or located upon clinical examination. Discharge from the fistula, which must be differentiated from a draining sinus,  often results in a visibly wet face. The salivary discharge from a fistula is usually golden or blood tinged saliva, which will be viscous and 'stringy' in appearance. The presence of mucous can be confirmed by using periodic acid-schiff stain if necessary.
*Discharge from fistula (must be differentiated from a draining sinus) resulting in a visibly wet face  
 
*History or current presence of a wound over the parotid region<br>
 
  
Differentiation from a draining sinus by assessment of the discharge- salivary fistula will discharge a golden or blood tinged saliva, which will be viscous and 'stringy' in appearance. Mucous can be identified in this by use of periodic acid-schiff stain if neccesary.<br>&nbsp;
+
History of or current presence of a wound over the parotid regionis a very good indicator.
  
 
== Treatment  ==
 
== Treatment  ==
  
Surgical ligation of the duct proximal to the injury&nbsp;will usually resolve the problem (complete removal of the gland can be performed if neccesary). Removal of the parotid gland is not usually performed due to high risk of complications such as cranial nerve trauma.  
+
Surgical ligation of the duct proximal to the injury will usually resolve the problem. Complete removal of the gland can be performed if necessary. However, removal of the parotid gland is not usually performed due to the high risk of complications such as cranial nerve trauma.  
  
Skin is incised over the duct on side of face (beware of buccal nerves) and a wide diameter suture material can be used&nbsp;to cannulate the duct in order to aid locating it during surgery.<br>Occasionally a mucocele may develop from the site of surgery. <br>
+
The skin is incised over the duct on the side of thebface (beware of buccal nerves) and a wide diameter suture material can be used to cannulate the duct in order to aid locating it during surgery.
  
== References <br> ==
+
Occasionally a [[Salivary Mucocele|mucocele]] may develop from the site of surgery.
 +
 
 +
== References ==
  
 
Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5 th Ed
 
Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5 th Ed
Line 32: Line 27:
  
  
 +
{{review}}
 +
 +
{{OpenPages}}
  
[[Category:Salivary_Glands_-_Pathology]] [[Category:To_Do_-_Review]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]
+
[[Category:Salivary_Glands_-_Pathology]] [[Category:Expert_Review - Small Animal]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]

Latest revision as of 12:39, 9 August 2012


Introduction

A salivary fistula can result from injury to any salivary gland, but most commonly the parotid. Fistulas forming from other glands is uncommon. Damage may be due to traumatic wound to the face e.g. bite wound or abscess drainage. Exopthalmus is the most likely cause of zygomatic fistula. The continuous flow of saliva due to trauma to the face prevents healing and therefore a fistula develops. Discharge from the gland may be noticeably worse before or during feeding.

Diagnosis

Diagnosis is largely made from clinical signs and history.

The fistula is often visible over the parotid region, or located upon clinical examination. Discharge from the fistula, which must be differentiated from a draining sinus, often results in a visibly wet face. The salivary discharge from a fistula is usually golden or blood tinged saliva, which will be viscous and 'stringy' in appearance. The presence of mucous can be confirmed by using periodic acid-schiff stain if necessary.

History of or current presence of a wound over the parotid regionis a very good indicator.

Treatment

Surgical ligation of the duct proximal to the injury will usually resolve the problem. Complete removal of the gland can be performed if necessary. However, removal of the parotid gland is not usually performed due to the high risk of complications such as cranial nerve trauma.

The skin is incised over the duct on the side of thebface (beware of buccal nerves) and a wide diameter suture material can be used to cannulate the duct in order to aid locating it during surgery.

Occasionally a mucocele may develop from the site of surgery.

References

Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5 th Ed

Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
Merck & Co (2008) The Merck Veterinary Manual




Error in widget FBRecommend: unable to write file /var/www/wikivet.net/extensions/Widgets/compiled_templates/wrt6635ff237d1558_91667575
Error in widget google+: unable to write file /var/www/wikivet.net/extensions/Widgets/compiled_templates/wrt6635ff23809b93_89271340
Error in widget TwitterTweet: unable to write file /var/www/wikivet.net/extensions/Widgets/compiled_templates/wrt6635ff23840896_27093534
WikiVet® Introduction - Help WikiVet - Report a Problem