Difference between revisions of "Salivary Fistula"

Revision as of 16:54, 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 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.

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 if neccesary.

Treatment

Surgical ligation of the duct proximal to the injury 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.

Skin is incised over the duct on side of face (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

@@ Line 1: / Line 1: @@
-{{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;
+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&nbsp;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 is largely made from clinical signs and history.
+=== Clinical Signs  ===
-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.
+*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>
-History of or current presence of a wound over the parotid regionis a very good indicator.
+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;
 == 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.
+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.
-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.
+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>
-Occasionally a [[Salivary Mucocele|mucocele]] may develop from the site of surgery.
+== References <br> ==
-== References ==
 Ettinger, S.J., Feldman E.C. (2000) Textbook of Veterinary Internal Medicine 5 th Ed
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-{{review}}
-{{OpenPages}}
-[[Category:Salivary_Glands_-_Pathology]] [[Category:Expert_Review - Small Animal]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]
+[[Category:Salivary_Glands_-_Pathology]] [[Category:To_Do_-_Review]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]]