Salivary gland fistula

Salivary gland fistula is a pathological condition characterized by an abnormal connection (fistula) between a salivary gland and the skin or the oral cavity. This condition can occur as a result of trauma, surgery, or infection and can lead to various complications such as recurrent sialadenitis, salivary gland swelling, and persistent salivary leakage.

Etiology

The most common cause of salivary gland fistula is trauma, either accidental or surgical. Accidental trauma can occur due to a penetrating injury to the face or neck, while surgical trauma can occur during procedures involving the salivary glands or surrounding structures. Infections, particularly those caused by Staphylococcus aureus, can also lead to the formation of a fistula.

Pathophysiology

A salivary gland fistula forms when there is a breach in the integrity of the salivary gland or its duct system. This allows saliva to leak out and form a tract to the skin or oral cavity. The constant flow of saliva through this tract can prevent it from healing, leading to the formation of a permanent fistula.

Clinical Presentation

Patients with a salivary gland fistula typically present with persistent salivary leakage from a small opening in the skin or oral cavity. This can lead to skin irritation and infection. Other symptoms can include pain, swelling of the affected salivary gland, and recurrent episodes of sialadenitis.

Diagnosis

The diagnosis of a salivary gland fistula is usually made based on the patient's history and clinical examination. Imaging studies such as ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) can be used to confirm the diagnosis and assess the extent of the fistula.

Treatment

The treatment of a salivary gland fistula depends on its cause, location, and severity. Conservative measures such as pressure dressings and antibiotics may be used in mild cases. In more severe cases, surgical intervention may be required to close the fistula and restore the integrity of the salivary gland.

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