parotid duct anastomosis

Parotid duct anastomosis is used for reconstruction of the parotid duct. Paralysis of the parotid duct due to trauma or surgery may cause leakage or loss of the catheter. Therefore, catheter reconstruction must be actively carried out. Various reconstruction procedures are selected based on their indications. In recent years, the author (unit) has succeeded in using the proximal gland end anastomosis of the vein and residual catheter in the front. Treatment of diseases: parotid gland infection Indication Parotid duct anastomosis is suitable for acute catheter injury with no defects in the catheter. Contraindications 1. The catheter has obvious defects. 2. Local inflammation or tumor. Preoperative preparation 1. Inject methylene blue from the mouth and the catheter mouth 1 day before surgery; prepare a lacrimal sac probe and a hollow hose. 2. Determine the site of injury by parotid angiography. 3. Remove intraoral infections. 4. Other routine preparations before oral and maxillofacial surgery. Surgical procedure Incision A fusiform incision parallel to the catheter is made at the fistula formed after the catheter is injured, that is, the skin around the fistula is removed by a fusiform shape. The incision is about 2 to 3 cm long. 2. Reveal After cutting the skin and subcutaneous tissue, bluntly separate along the direction of the catheter, first looking for the proximal gland duct. Because the methylene blue has been injected before surgery, it is generally looking for a smooth, in case of difficulties, you can use a dry cotton ball to wipe while searching. At this time, there will be sputum outflow, which is conducive to finding. Because of the scar contracture, it is more difficult to find the end of the gland. Although methylene blue is injected from the mouth before surgery, it is difficult to inject deeper parts due to narrowing or clogging of the catheter. At this point, the lacrimal sac probe can be used to slowly penetrate from the intraoral catheter port. Then, the probe was taken out, placed in a hollow hose, the catheter end was trimmed, and the hollow catheter was fed 2 cm from the broken end. Finally, the broken end is sutured with a 5-0 suture for 4-6 needles (Fig. 10.5.1.2.1-1, 10.5.1.2.1-2). 3. Close the wound and fix the hollow hose The wound was closed by stratification, and the hollow rubber tube was sutured in the mouth and the pressure was wrapped outside the mouth. complication The main reasons for reclamation are: 1 there is an invalid cavity in the damaged part; the hollow rubber tube falls off prematurely. 2 There is tension, which occurs in the long defect of the catheter, barely pulls the suture, causing the anastomosis to tear, and then forming a reclamation.