A 79-year-old woman visited our emergency department with three stab wounds in her right preauricular area (). We found no abnormal finding during the retrograde irrigation test for Stensen duct that was performed in the ampulla. However, facial expressions such as the area around the mouth and blinking of the eyes were unnatural, so the possibility of facial nerve injury could not be ruled out. An emergency exploration was performed under general anesthesia in the operating room. To minimize additional injuries and conduct a more reliable exploration of the injured areas, the wounds were connected to expose all the injured areas. Even though more dead space was created due to this procedure, we definitely found injuries in the parotid glands and an injury at a marginal mandible branch of the facial nerve (). After neurorrhaphy for the facial nerve injury, the wound was sutured, and a closed 100-mL Jackson-Pratt drainage tube was inserted (). The injured parotid gland area was not wide in size and the tissue was soft, so it was not repaired.\nAs postoperative management, oral administration of 10 mg nortriptyline once daily for 3 weeks was started from the day of surgery to prevent secondary complication, such as infection due to persistent salivation. During treatment with nortriptyline, the patient complained of mouth dryness, which showed that the drug had an anticholinergic action. The drainage tube was removed on the 6th day after the surgery, when 5 mL per day or less drainage was collected for 3 days in a row. Due to the possibility of partial wound dehiscence, delayed stitch out was planned, and all sutures were removed on the 10th postoperative day. Complete and unremarkable wound healing was observed, and no complications were reported 7 weeks postoperatively ().
A 27-year-old male was treated with ORIF for right subcondylar fracture via retromandibular approach. Again discharge of colorless, odorless watery fluid from right parotid region was noticed after second postoperative day, Diagnosis of parotid fistula was made and treated with hypertonic saline injections.\nWarm hypertonic saline (60°C) was injected after flushing with Betadine followed by pressure dressing and antisialagogue drugs were given for 5 days. On the fifth day of this course the fistulous tract healed spontaneously and there were no associated complications. Patient is on continuous follow-up since 3 months and there are no complications reported till date [].