A 32-year-old male patient presented with the complaints of watery discharge from a wound over the left parotid region for the past 8 months. The fistula had started 2 weeks after he had undergone superficial parotidectomy for pleomorphic adenoma. The patient was diagnosed as a case of postparotidectomy parotid fistula and initially treated conservatively with regular pressure dressing, anticholinergics, and antibiotics, but symptoms were not relieved. Subsequently, the patient had also developed features of Frey's syndrome 7 months after the surgery.\nThe patient was diagnosed with simultaneous parotid fistula and Frey's syndrome []. Forty units of BTA was injected subcutaneously in the parotid region. There were no complications such as facial nerve injury and facial artery or masseter muscle trauma. The parotid fistula got resolved within 4 days with complete closure of the fistulous opening and gustatory sweating (Frey's syndrome) ceased after 6 days []. There was no recurrence later, after a follow-up period of 1 year.
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 ().