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.
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.