Definition and Overview
- Salivary gland fistula is a medical condition involving an abnormal connection between a salivary gland and another structure.
- It is characterised by the leakage of saliva from the affected gland.
- The condition can be congenital or acquired, with trauma or surgery being common causes.
- Salivary gland fistulas can occur in any of the major salivary glands, including the parotid, submandibular, and sublingual glands.
- Symptoms may include persistent drooling, swelling, and recurrent infections in the affected area.
Causes and Risk Factors
- Trauma, such as facial fractures or penetrating injuries, can lead to the development of salivary gland fistulas.
- Surgical procedures involving the salivary glands, such as tumor removal or duct repair, can also result in fistula formation.
- Infections, such as abscesses or chronic inflammation, can contribute to the development of fistulas.
- Certain medical conditions, such as Sjögren's syndrome or salivary gland stones, may increase the risk of fistula formation.
- Poor oral hygiene and dental infections can also be risk factors for salivary gland fistulas.
Diagnosis and Evaluation
- A thorough medical history and physical examination are essential for diagnosing salivary gland fistulas.
- Imaging tests, such as ultrasound, CT scans, or MRI, can help identify the location and extent of the fistula.
- Sialography, a procedure involving the injection of a contrast dye into the salivary ducts, may be performed to visualize the fistula.
- Salivary flow rate measurements can be used to assess the severity of the condition.
- Biopsy of the affected gland may be necessary to rule out other underlying causes.
Treatment Options
- Conservative management, including observation and supportive measures, may be sufficient for small and asymptomatic fistulas.
- Antibiotics may be prescribed to treat or prevent infections associated with the fistula.
- Salivary gland massage and warm compresses can help promote drainage and healing.
- In some cases, surgical intervention may be required to repair the fistula and restore normal salivary gland function.
- Surgical techniques may include fistula closure, duct rerouting, or removal of the affected gland.
Prognosis and Complications
- The prognosis for salivary gland fistulas is generally good with appropriate treatment.
- Early diagnosis and intervention can help prevent complications, such as recurrent infections or damage to nearby structures.
- In some cases, fistulas may recur or persist despite treatment, requiring further interventions.
- Long-term complications, such as salivary gland dysfunction or chronic dry mouth, may occur in some individuals.
- Regular follow-up with a healthcare provider is important to monitor the condition and manage any potential complications.
A salivary gland fistula (plural fistulae) is a fistula (i.e. an abnormal, epithelial-lined tract) involving a salivary gland or duct.
Salivary gland fistulae are almost always related to the parotid gland or duct, although the submandibular gland is rarely the origin.
The fistula can communicate with the mouth (usually causing no symptoms), the paranasal sinuses (giving rhinorrhea) or the facial skin (causing saliva to drain onto the skin).
The usual cause is trauma, however salivary fistula can occur as a complication of surgery, or if the duct becomes obstructed with a calculus.
Most parotid fistulae heal by themselves within a few weeks.
