A Functional Approach to Posttraumatic Salivary Fistula Treatment: The Use of Botulinum Toxin

This manuscript highlights key aspects regarding the practical use of botulinum toxin for the conservative nonsurgical treatment of a rarely encountered, but significant posttraumatic complication—the parotid salivary fistula. It adds information to the scarce existing literature on the subject. The authors outline the main differences between postoperative and trauma-related parotid injury regarding salivary fistula treatment. A total of 6 patients with trauma-related salivary fistulas have been treated by Abobotulinum toxin A injections over the course of 5 years. The technique is detailed, describing the doses used in the presence of parenchyma and duct injuries, the location and number of injection points in relation to the wound pattern. The results were favorable, leading to the healing of the salivary fistulas in all patients, with 1 injection session, without additional conservative treatment. In our experience, the use of botulinum toxin is of great benefit for treating salivary fistulas in a traumatic context. Address correspondence and reprint requests to Marius Gabriel Dabija, MD, PhD, Neurosurgery, Department of Surgery II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street, No 16, 700115 Iasi, Romania; E-mail: mariusdabija.md@gmail.com Received 25 June, 2018 Accepted 3 December, 2018 The authors report no conflicts of interest. © 2019 by Mutaz B. Habal, MD.

https://ift.tt/2EpRA0q