A 1-year-old girl presented with serous discharge from the right cheek since birth which increased on chewing. On examination, there was a 1 mm × 1 mm cutaneous opening over the right cheek, 2 cm lateral to the angle of the mouth along with bilateral preauricular skin tags []. Intraoral examination and duct opening of parotid and submandibular gland was normal on both sides. Sinogram with a 24G cannula showed a thin tubular tract directed posteromedially from the external opening on the cheek into the region of the Stensen's duct/parotid gland []. There was no communication with the oral cavity or mandible. Under general anesthesia, the external opening was cannulated with a 24G intravenous plastic cannula and methylene blue injected []. With circumferential fine dissection around the external opening, the fistula tract was separated from the skin and subcutaneous fat of the cheek and brought into the oral cavity. Further intraoral dissection showed the tract initially going vertically down for 2 cm then turning posteriomedially for 1 cm to finally opening into the right Stensen's duct near the lower part of the parotid gland []. The fistulous tract was transfixed and ligated at its origin in the duct and excised in toto []. At 1-year follow-up, she has a negligible scar with a good cosmetic outcome [].
A 37-year-old male patient reported to the Department of Oral and Maxillofacial Surgery with a chief complaint of pain, difficulty in closing the mouth, and swelling on the left side of the face following a road traffic accident. Direct open reduction and internal fixation via transparotid approach of the left condyle were performed []. Ten days later, the patient presented with a swelling on the left side of the face. On extraoral examination, there were no clinical signs of infection or drainage in the surgical wound and no local rise in temperature was noted. On intraoral examination, salivary secretion through the stenson's duct was relatively reduced on the left side. Neurological examination revealed that no motor loss due to severance of any branch of facial nerve in the affected side. Aspiration was done on dependable swelling which gained a 6 ml of clear, watery, and odorless fluid aspirate, giving an impression of saliva []. A laboratory test confirmed the presence of salivary amylase in the aspirate.\nIn this case, trauma in the parotid glandular substance leads to the formation of sialocele by the accumulation of extravasated saliva into the glandular parenchyma. Pressure dressing and antibiotics were given to prevent infection. Postoperatively, repeated aspiration along with compressive dressing was performed but did not result in healing. Hence, decided to place an intraoral drain under local anesthesia.\nAfter standard aseptic preparation, intraorally, a 1 cm long incision was placed on external oblique ridge behind the third molar. A small curved artery forceps were inserted through the superficial fascia of masseter reaching the sialocele. Approximately 5 cm long, slender, sterile, punched plastic tube of diameter 5 mm (intravenous cannula) [] was positioned with one end in the glandular substance and the other end in the mouth with the help of the forceps. The tube was secured along the vestibule by suturing it to the mucosal surface of the cheek, ensuring complete convenience to the patient []. After placing such a drain, there was no pooling of saliva in the glandular substance. This would have allowed healing of the gland and subsequent formation of structures necessary for drainage through the main Stensen's duct. The patient's recovery was uncomplicated, and follow-up was done for 5 months.