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Clinical Anatomy, 2004
Although there is a great amount in the literature to describe the anatomy of the parotid gland as a whole, little attention is given to the parotid duct. The purpose of this study is to examine the surgical anatomy of the parotid duct with special emphasis placed on the major tributaries forming the parotid duct and the relationship of the facial nerve to the duct. Twenty-nine fresh cadaver halves were dissected and the branching pattern of the ducts, position within the parotid, and their relationship to the facial nerve were studied. Of the complete heads studied, the parotid duct had the same pattern in 78.6% on the right and left sides. The parotid ducts in 31.0% of the half heads presented as a single discernible duct from parotid papilla to within the gland. In 62.1% of the half heads, the ducts were formed by a branching pattern within the gland. In the ducts with a branching pattern, 48.3% displayed a bifurcated pattern, 6.9% were trifurcated, and 6.9% had multiple branches. In 6.9% of the half heads studied, the parotid ducts bifurcated distal to the parotid gland. In all cases, the deep lobe of the parotid enveloped the parotid duct; only small ductules connected the superficial lobe with the duct. The facial nerve and its branches were always observed lateral to the parotid duct. Because one dissects lateral to the facial nerve during a superficial parotidectomy, generally the parotid duct remains intact and potential complications such as facial paralysis, sialoceles, and fistulizations are thereby minimized.
Management of Parotid Duct Injuries
Oral surgery, oral medicine, oral pathology, …, 2005
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Parotid duct injury: is immediate surgical repair necessary?
Injury, 1991
This prospective study invwtigated he outcome for non-operafive management of parotid duct injuries in 19 patients with injury confirmed by Ihe methylene blue method. Nine (47 per cent) healed without complications. Short-term salivary fistula.~ complicated seven (36.8 per cent) wounds and a sialocele occurred in four (21. I per cent). All complications resolved roithout the need for operative inkroention. Acute surgical repair of damaged duck can no longer be recommended, since conservative management of parotid duct trauma is both safe and effective; simple surgical procedures exisf for the management of the rare long-term disorders.
Folia morphologica, 2007
There have been studies concerning the protection of the facial nerve during plastic surgery intended for the parotid gland. The close relationship between the parotid duct and the buccal and zygomatic branches of the facial nerve is studied here. The dissections were performed on 10 fixed cadavers at the Anatomy Dissection Laboratory of Ankara University in 2004. The reference points used for surgery of this region were taken into consideration as the landmarks for morphometric measurements. In 7 of the cases the zygomatic branch was double and in 3 it was single. In 4 of the 7 cases with a double zygomatic branch both superior and inferior branches crossed the parotid duct. In the remaining 3 cases the superior branches of the zygomatic nerve coursed through the zygomatic major and minor muscles. In 9 of all the cases the zygomatic branch of the facial nerve crossed the duct anteriorly and in one it did so posteriorly (case 10). The buccal branch was single in 4 of the cases and d...
Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 2019
Parotid duct injuries (PDIs) are not considered common complications of facial trauma. However, their associated morbidity may be increased by the formation of parotid sieloceles and fistulae. This article reports the case of a 31-year-old male patient who was presented to the emergency department of Evangelismos General Hospital of Athens, due to a sharp penetrating injury on left side of his face. Since transection of PD was clinically diagnosed, an end-to-end anastomosis was immediately carried out under local anesthesia. Within the early postoperative period, various angiocatheters of progressively increased diameters were used for stenting the repaired PD. After 10 months of follow-up, there were no clinical and ultrasonographic signs of sialocele or fistula formation. This case report aimed first to underscore the benefits of immediate surgical management in case of PDIs and second, to describe the postoperative management for maintenance of both PD patency and parotid gland function. PDIs in the context of emergency facial trauma are advisable to be timely recognized and treated immediately, by securing the saliva outflow to the oral cavity and maintaining a wide enough ductal lumen.
Parotid Gland with Double Duct: An Anatomic Variation Description
Int. J. Morphol, 2009
The parotid is the largest salivary gland in humans producing an essentially serous secretion, which normally reaches the oral cavity through a sole duct (the parotid duct) after the latter making its way through the buccinator muscle to reach the mucosa lining the mouth at the level of the cheek. The present study reports on a rare case of double parotid duct found during the dissection the right side of the face of a cadaver of a 46-year-old male individual. The superior (D1) and inferior (D2) ducts were 26.49 mm and 37.25 mm long, respectively. Based on the diameter of both ducts (D1 and D2) taken in the posterior (3.05 mm and 2.84 mm, respectively) and mid (2.84 mm and 2.68 mm, respectively) thirds, as well as on the histological findings, both ducts were considered to be main parotid ducts. These two ducts merged at the level of the anterior third forming one sole opening into the oral cavity. The data hereby reported are relevant to the various clinical and surgical procedures involving the parotid gland.
Penetrating Trauma to the Parotid Gland
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
P enetrating trauma to the parotid region is a rare condition and usually occurs after a gunshot injury, but can also be seen as a result of occupational accidents. Parotid tissue together with surrounding tissues, parotid duct, facial nerve, mandibular bone, and other adjacent structures may be damaged depending on the severity of penetrating trauma. Early diagnosis and intervention are important in minimizing complications. In this study, the diagnosis and treatment options are discussed in two different cases with penetrating trauma to the parotid region treated in our clinic. Case Report Case 1-A 20-year-old male patient with a history of gunshot injury to his face happened a week ago was admitted to our clinic in March 2017 with the complaint of restricted mouth opening. On examination, vital signs were stable, left maxillary, the infraorbital lesion on the maxillary bone, consistent with the bullet entry hole, and a skin burn Penetrating trauma to the parotid gland is a rare condition. Mostly, gunshot wounds to the parotid area are seen. Facial paralysis and sialocele formation are particular concerns and may cause significant morbidities. Early diagnosis and early exploration are crucial in the setting of facial paralysis following penetrating trauma. Sialocele formation and fistulas can be managed conservatively or surgically.
Status of the remaining parotid duct and gland following superficial parotidectomy
European Archives of Oto-rhino-laryngology, 2008
The changes in Stensen’s duct and remaining parotid tissue following superficial parotidectomy have not been studied previously. The aim of this clinical case control study is to describe these changes using sialography and CT-sialography techniques. Fourteen superficial parotidectomy cases underwent parotid sialography bilaterally. CT sialography was also done. Stensen’s duct was patent in 11 cases (79%), and non-patent in three cases (21%). Its angle in relation to our reference line was 20° in operated cases versus 37° for the non-operated cases. Following superficial parotidectomy, the remaining parotid tissues usually remain functional and retain drainage through Stensen’s duct. Furthermore, superficial parotidectomy changes the direction of this duct. Parotid sialography and CT sialography can still be used to study the status of remaining parotid tissue following superficial parotidectomy. The post-surgical changes should be reviewed with care before interpreting these studies.
New approaches in parotid gland surgery
Annals of the Royal Australasian College of Dental Surgeons
Various skin incision for access to the parotid region are described by different authors, which differ in extension and localization of the scar. Therefore after parotidectomy, patients are often left with a retromandibular and cervical depression. Maintaining normal facial contour may be difficult in parotidectomy defects, but a good symmetry can and should be achieved when reconstructing the parotid region with a specific approach. The authors show their experience in parotid gland surgery using a new skin incision to improve the aesthetic and functional results and three different techniques the reconstruction of the parotid region.
‘Y’ Shaped right Parotid duct - a rare anatomical presentation
International Journal of Basic and Applied Sciences, 2015
The parotid gland with two ducts is a rare anomaly and very few cases have been reported in the literature. The Present study was conducted in the postgraduate Department of Anatomy at Government Medical College Srinagar to study the variations in the pattern and number of ducts of parotid gland during routine dissection for academic purposes between 2001-20014. Both parotid glands of 36 Indian cadavers were dissected out for routine anatomic teaching and simultaneously recording observations. In this study we also included 10 formalin preserved specimens of parotid gland. It was observed that in one of the cadavers two ducts emerged from the anterior border of right parotid gland. These ducts D1 (superior) and D2 (inferior) joined after crossing the anterior border of the masseter muscle and formed a common duct (D3) in the form of letter 'Y', which pierced the buccal pad of fat, buccopharngeal fascia, buccinator muscle and mucous membrane before opening inside the vestibule of mouth. This anomalous duct pattern though rare is of great academic and clinical significance in Otorhinology, Maxillofacial and Plastic surgery, where it may explain the occurrence of post traumatic/iatrogenic parotid fistulas and need for preoperative sialography during surgical procedures of this region.