Iatrogenic Obstructive Sialadenitis of the Parotid and Submandibular Glands Following Facial Rejuvenation

During facial rejuvenation procedures, the salivary glands and their ducts are susceptible to injury. Given the paucity of data on obstructive salivary gland complications after facial rejuvenation procedures, this study aimed to characterize their clinical features and assess the outcomes of endoscopic management.

A tertiary salivary gland clinic database was retrospectively reviewed for patients who presented with obstructive sialadenitis involving the parotid and submandibular glands following facial rejuvenation procedures and were treated with sialendoscopy. Demographic, clinical, and outcome data were collected from the files.

The cohort included 11 patients (8 women, 3 men) with a mean age of 59±5.1 years. The mean follow-up time was two years. Patients presented with gland swelling, pain, xerostomia, hypersalivation, and pruritus. Physical examination indicated parotid involvement in 8 cases and submandibular gland involvement in 3. Preoperative imaging studies revealed gland swelling, ductal system dilation, and ductal strictures. A convoluted and atrophic ductal system with cloudy sediments was frequently observed during surgery. Most patients required multiple sialendoscopic procedures. While the majority were successfully treated endoscopically, one patient required adjunctive open repair for a persistent parotid cutaneous fistula using a sternocleidomastoid muscle flap.

This study presents the most comprehensive case series on obstructive sialadenitis of the parotid and submandibular glands following FRPs. These complications may result in significant morbidity. Sialendoscopy is an effective treatment for these conditions. Proper clinical assessment in the office and operating room is crucial for accurate diagnosis and effective treatment.

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