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.
An 8-month-old male child presented with salivary discharge from the right cheek since birth. On inspection, there was a 1 mm external fistulous opening, 2 cm from the angle of the mouth with ipsilateral preauricular appendage. Intraoral examination was normal. On sinogram, no obvious tract could be identified. Under general anesthesia, cannulation of external fistulous opening was extremely difficult due to its very narrow caliber. A 24G plastic cannula could be passed for only 5 mm through which methylene blue dye was injected. Similar dissection was done as in the previous case with the tract being dissected externally and transposed intraorally. Diffuse intraoral discoloration by the dye was noted and insufficient length of cannula within the duct made identification of further intraoral tract difficult and the procedure had to be abandoned. The preauricular skin tag was excised. Postoperatively, there was local edema and a small dry ulcer over the cheek []. It eventually healed with secondary intention. At 1-year follow-up, there is no external salivary discharge with good cosmetic outcome.