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Suggest Treatment For Excess Saliva After Stab Injury To Salivary Glands

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Posted on Thu, 10 Apr 2014
Question: have had an injury to my paroted gland (stabbed through the cheek) and before it completely healed it use to squirt outside my cheek for months especially when I chewed. Now that years have gone by it looks like a golf ball on my cheek. I don't notice anything wrong with saliva in my mouth. It's the disfigurement that drives me crazy! I've been to a plastic surgeon but they say there's not much they can do because I have little fatty ___ in my inner cheek that is normally cut out to compensate for the large swelling on the outside of me cheek.
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Answered by Dr. Deepak Kishore Kaltari (2 hours later)
Brief Answer: No other symptoms then better left undisturbed Detailed Answer: Hi Greetings of the day Stab injury to Salivary glands are usually complicated by discharge of saliva occurring outside through cheek known as Cutaneous Salivary Fistula. If the leak is of high output they do no heal spontaneously, it will require surgical intervention. Few heal spontaneously over period of time, but may be complicated by intense inflammatory response and scarring of the gland causing disfigurement due to the size. As it's a chronic inflammation nothing much can be done , as in your case. Further management as in your case will depend on 1. Clinical assessment of Size and consistency. 2. Presence of fistula 3. If there are other symptoms like pain If your fistula has closed, there is no pain and the oral cavity is normal and also ultrasound of the parotid does not reveal any suspicious lesion then it's better left undisturbed. Surgical excision will be really difficult due to chronic infection leading to loss of surgical planes and also increased risk of damage to Facial nerve . Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Deepak Kishore Kaltari (47 hours later)
Do you recommend 1) I see a gland doctor? 2) Go to the surgeon that stitched it at the hospital? 3) See another plastic surgeon? It really bothers me. I'm with the public daily and often get asked what's wrong with my cheek or do you have a toothache? It looks like a golf-ball sticking out on my cheek. What about having it reduced somehow? I just don't understand why it has to be so big it gives me facial disfigurement!
doctor
Answered by Dr. Deepak Kishore Kaltari (32 minutes later)
Brief Answer: Consult Gland Surgeon Detailed Answer: Hi I would suggest you to either seek opinion of gland surgeon or Oro-faciomaxillary Surgeon if available . Cosmetic disfigurement is definitely indication for Surgical intervention to be done. Wishing you great health. Take Care Regards Deepak
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3195 Questions

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Suggest Treatment For Excess Saliva After Stab Injury To Salivary Glands

Brief Answer: No other symptoms then better left undisturbed Detailed Answer: Hi Greetings of the day Stab injury to Salivary glands are usually complicated by discharge of saliva occurring outside through cheek known as Cutaneous Salivary Fistula. If the leak is of high output they do no heal spontaneously, it will require surgical intervention. Few heal spontaneously over period of time, but may be complicated by intense inflammatory response and scarring of the gland causing disfigurement due to the size. As it's a chronic inflammation nothing much can be done , as in your case. Further management as in your case will depend on 1. Clinical assessment of Size and consistency. 2. Presence of fistula 3. If there are other symptoms like pain If your fistula has closed, there is no pain and the oral cavity is normal and also ultrasound of the parotid does not reveal any suspicious lesion then it's better left undisturbed. Surgical excision will be really difficult due to chronic infection leading to loss of surgical planes and also increased risk of damage to Facial nerve . Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Surgeon