Difference between revisions of "Salivary Fistula"
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| − | == Description == | + | == Description == |
| − | 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. Fistulas forming from other glands is uncommon. |
Injury may be due to: | Injury may be due to: | ||
| − | *Traumatic wound to the face e.g. bite wound | + | *Traumatic wound to the face e.g. bite wound |
| − | *Abscess drainage | + | *Abscess drainage |
| − | *Iatrogenic rupture following prior surgery in the region | + | *Iatrogenic rupture following prior surgery in the region |
*Exopthalmus is the most likely cause of zygomatic duct injury | *Exopthalmus is the most likely cause of zygomatic duct injury | ||
| − | The continuous flow of saliva prevents healing and therefore a fistula develops | + | 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> | + | 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 === | + | === Clinical Signs === |
| − | *Fistula visible over parotid region, or located upon clinical examination | + | *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 | + | *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 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. | + | 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> |
| − | == Treatment == | + | == Treatment == |
| − | Surgical ligation of the duct | + | 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. |
| − | == References == | + | 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.<br>Occasionally a mucocele may develop from the site of surgery. |
| + | |||
| + | == References == | ||
Merck & Co (2008) '''The Merck Veterinary Manual''' | Merck & Co (2008) '''The Merck Veterinary Manual''' | ||
[[Category:Salivary_Glands_-_Pathology]] [[Category:To_Do_-_Kate]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]] | [[Category:Salivary_Glands_-_Pathology]] [[Category:To_Do_-_Kate]] [[Category:Oral_Diseases_-_Dog]] [[Category:Oral_Diseases_-_Cat]] | ||
Revision as of 16:46, 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 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
Merck & Co (2008) The Merck Veterinary Manual