Wound of the Parotid Duct Following a Subcondylar Fracture

J Oral Maxillofac Surg. 2022 Jan;80(1):137.e1-137.e6. doi: 10.1016/j.joms.2021.08.269. Epub 2021 Sep 6.

Abstract

Salivary gland and duct complications following surgical approaches to condylar fractures are well known, particularly in approaches requiring parotid tissue dissection. We report a rare case of a parotid duct wound caused by the fracture itself and due to a lateral displacement of the condylar fragment. Four days after the surgical management of a trifocal mandibular fracture (head fracture on the left side, laterally displaced condylar base and angular fracture on the right side) the patient presented with a fluctuating subcutaneous swelling in the right cheek, evoking a sialocele. The sialography showed a massive leak of iodinated contrast medium just in front of the parotid hilum, joining the subcutaneous undermining made during the approach and confirmed the diagnosis of a parotid duct wound. A pressure dressing was applied to the right mandibular angle for 2 weeks, allowing for complete remission. In conclusion, this unusual clinical case illustrates the fact that the parotid duct may be endangered in the event of condylar base fractures, not only by the surgical approach but also by the fracture itself, especially when there is severe lateral displacement.

Publication types

  • Case Reports

MeSH terms

  • Fracture Fixation, Internal
  • Humans
  • Mandible
  • Mandibular Condyle / diagnostic imaging
  • Mandibular Condyle / surgery
  • Mandibular Fractures* / diagnostic imaging
  • Mandibular Fractures* / surgery
  • Parotid Gland / diagnostic imaging
  • Parotid Gland / surgery
  • Salivary Ducts / diagnostic imaging
  • Salivary Ducts / surgery
  • Sialography