Facial plast Surg 2010; 26(6): 504-510
DOI: 10.1055/s-0030-1267725
© Thieme Medical Publishers

Parotid Gland Trauma

Eli A. Gordin1 , James J. Daniero1 , Howard Krein2 , Maurits S. Boon3
  • 1Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, Pennsylvania
  • 2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, Pennsylvania
  • 3Division of Voice and Swallowing Disorders, Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
17 November 2010 (online)

ABSTRACT

Parotid trauma can lead to both short and long-term complications such as bleeding, infection, facial nerve injury, sialocele, and salivary fistula, resulting in pain and disfigurement. Facial injuries inferior to a line extended from the tragus to the upper lip should raise concern for parotid injury. These injuries can be stratified into three regions as they relate to the masseter muscle. Injuries posing the greatest risk of damage to Stensen's duct include those anterior to the posterior border of the masseter and necessitate exploration. When the duct is disrupted, emphasis should be placed on primary repair or re-creation of the papilla; however, proximal ductal lacerations can be treated by ligation of the proximal segment. Isolated parenchymal injury can be treated with more conservative means. Sialocele and salivary fistula can frequently be managed nonoperatively with antibiotics, pressure dressings, and serial aspiration. Anticholinergic medications and the injection of botulinum toxin represent additional measures before resorting to surgical therapies such as tympanic neurectomy or parotidectomy.