Difference between revisions of "Salivary Fistula"

Revision as of 16:35, 1 March 2011

Description

A salivary fistula can result from injury to any salivary gland, but most commonly the parotid. Fistulas forming from other glands is uncommon.

Injury may be due to:

Traumatic wound to the face e.g. bite wound
Abscess drainage
Iatrogenic rupture following prior surgery in the region
Exopthalmus is the most likely cause of zygomatic duct injury

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.

Diagnosis

Clinical Signs

Fistula visible over parotid region, or located upon clinical examination
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

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.

Treatment

Surgical ligation of the duct or complete removal of the gland is neccesary

References

Merck & Co (2008) The Merck Veterinary Manual

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-{{OpenPagesTop}}
+== Description ==
-== Introduction  ==
-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.
+A salivary fistula&nbsp;can result from&nbsp;injury to any salivary gland, but most commonly the parotid.&nbsp;Fistulas forming from other glands is uncommon.&nbsp;
-== Diagnosis  ==
+Injury may be due to:
-Diagnosis is largely made from clinical signs and history.
+*Traumatic wound to the face e.g. bite wound
+*Abscess drainage
+*Iatrogenic rupture following prior surgery in the region
+*Exopthalmus is the most likely cause of zygomatic duct injury
-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.
+The continuous flow of saliva prevents healing and therefore a fistula develops
-History of or current presence of a wound over the parotid regionis a very good indicator.
+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>
-== Treatment  ==
+== Diagnosis ==
-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.
+=== Clinical Signs ===
-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.
+*Fistula visible over parotid region, or located upon clinical examination
+*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>
-Occasionally a [[Salivary Mucocele|mucocele]] may develop from the site of surgery.
+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.
-== References ==
+== Treatment ==
-Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5 th Ed
+Surgical ligation of the duct or complete removal of the gland is neccesary
-Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier <br>Merck &amp; Co (2008) The Merck Veterinary Manual
+== References ==
-{{review}}
-{{OpenPages}}
+Merck &amp; Co (2008) '''The Merck Veterinary Manual'''
-[[Category:Salivary_Glands_-_Pathology]] [[Category:Expert_Review - Small Animal]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]
+[[Category:Salivary_Glands_-_Pathology]] [[Category:To_Do_-_Kate]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]