TMSS Medical College Journal

Parotid fistula is a very rare, unpleasant and painful complication following parotid abscess in the parotid region. Parotid fistula also may occur following surgery& Parotid injury. Numerous methods of treatment, conservative as well as aggressive, have been described with varying success and morbidity. This paper present a simple but effective and conservative method of treating this complication with the use of hot hypertonic saline. Keywords: Hypertonic saline, parotid fistula, use of saline as sclerosing agent

A parotid fistula is a rare and extremely unpleasant complication following Parotid abscess in the Parotid region. Parotid fistulae have been reported following secondary to drainage of parotid abscess, parotoidectomy, surgery in the temporomandibular joint (TMJ) region and the incidence reported is as high as 14%. Other causes of parotid fistulae include mandibular osteotomy, use of external pin fixation* and as a complication of facial fractures. Although there is consensus in the literature that acute parotid injury must be explored primarily and all injured structures be repaired accurately, the treatment of the chronic injury is controversial. Numerous methods of treatment, | conservative as well as aggressive, have been described with varying success and morbidity. Management options include pressure dressings and use of antisialagogues,® total parotidectomy, tympanic neurectomy,’ intraoral transposition of parotid duct,* radiation therapy,” use of botulinium toxin A," and use of fibrin glue.” In this paper we describe a simple but effective method of treating this complication with the use of hot hypertonic saline.