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Parotid gland trauma.

Eli A Gordin¹, James J Daniero, Howard Krein

¹Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, PA, USA. eagordin@gmail.com

Facial Plastic Surgery : FPS

|November 19, 2010

Summary

This summary is machine-generated.

Parotid trauma can cause bleeding, infection, and facial nerve injury. Prompt evaluation and management of facial injuries are crucial to prevent complications like salivary fistula and disfigurement.

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Area of Science:

Otolaryngology
Head and Neck Surgery
Trauma Surgery

Background:

Parotid gland trauma can lead to significant short-term and long-term complications.
These complications include bleeding, infection, facial nerve injury, sialocele, and salivary fistula, causing pain and disfigurement.

Purpose of the Study:

To outline the diagnostic considerations and management strategies for parotid trauma.
To stratify parotid injuries based on anatomical location relative to the masseter muscle and Stensen's duct.

Main Methods:

Review of anatomical landmarks for identifying parotid injuries, particularly facial injuries below the tragus-upper lip line.
Stratification of injuries based on proximity to the masseter muscle to assess risk to Stensen's duct.
Discussion of treatment options for Stensen's duct injuries, including primary repair, re-creation of the papilla, or ligation.
Overview of management for isolated parenchymal injury, sialocele, and salivary fistula, including conservative and surgical approaches.

Main Results:

Facial injuries inferior to the tragus-upper lip line warrant concern for parotid injury.
Injuries anterior to the posterior border of the masseter muscle pose the highest risk to Stensen's duct and require exploration.
Conservative management (antibiotics, pressure dressings, aspiration) is often effective for sialocele and salivary fistula.
Surgical options like tympanic neurectomy or parotidectomy are considered after less invasive measures.

Conclusions:

Accurate anatomical assessment is key to managing parotid trauma effectively.
A tiered approach to treatment, from conservative measures to surgical intervention, guides patient care.
Timely diagnosis and appropriate management can mitigate the severity of parotid trauma complications.