Reconstruction of traumatically avulsed parotid duct using buccal mucosa flap: report of a new technique

Injury to parotid duct is frequently overlooked especially in multiple injuries settings. Consequently they are rarely reported in the literature. Treatment of these injuries is highly controversial. Short series and anecdotal case studies claim success with various approaches such as nonsurgical management, simple ligation of the proximal duct with or without antisialagogues, microsurgical primary repair, creation of sialodocho-oral fistula, and vein-graft replacement. A novel technique of sialodochoplasty using buccal-mucosa pedicle flap is described in this report. Short-term result of this method in a 4-year-old boy with traumatic loss of right parotid duct was encouraging. Hypothetical advantages of this new operation are reviewed in the background of alternative procedures. It is concluded that buccal-mucosa flap technique appears to be a promising alternative in the management of parotid duct injuries.