Parotid Injuries and Fistulae

Successful treatment of parotid injuries depends on early recognition and intervention. Sequelae of inadequate diagnosis and treatment include parotid fistula and sialocele formation, which are inconvenient for the patient and more difficult to treat than the initial injury. This chapter addresses the different causes of a parotid fistula (glandular–ductal), classification, and diagnosis (history-taking, physical examination, and investigations). It also discusses the various methods of treatment, whether nonsurgical (wound care, antibiotic therapy, anticholinergic agents, pressure dressings, intermittent serial aspirations, botulinum toxin A, fibrin glue, and hypertonic saline sclerotherapy), or surgical. Moreover, this chapter discusses the possible complications of facial fistula and their management.