An unusual complication associated with hard palate mucosal grafts: presumed minor salivary gland secretion

Hard palate grafts are commonly used in eyelid reconstructive procedures as a replacement for posterior lamellar defects. Four patients are presented with an unusual complication after placement of a hard palate graft: presumed minor salivary gland secretion. They were experiencing stringy mucous discharge over the graft and along the eyelids, causing visual blurring. Removal of the graft in one patient and cryotherapy to the grafts in the others (presumably causing atrophy of the minor salivary gland tissue found within the grafts) allowed resolution of symptoms. The authors propose the application of cryotherapy to the graft surface to atrophy the salivary glands, prevent any further production of mucus, and return the tear film to a more normal consistency. Alternatively, surgical removal of the grafts can be performed. To our knowledge, this complication (saliva-like mucoid discharge) has not been previously reported.