RESUMO
Congenital parotid fistulas are extremely rare diseases. Herein, the authors report a patient with congenital salivary fistula from parotid main gland in a 15-year-old boy. Therefore, clinicians should consider the possibility of congenital parotid fistula form parotid main gland. Surgical excision of the fistula and parotid gland can be effective treatment option of congenital parotid fistula.
Assuntos
Fístula Cutânea/congênito , Glândula Parótida/cirurgia , Fístula das Glândulas Salivares/congênito , Adolescente , Fístula Cutânea/cirurgia , Humanos , Masculino , Fístula das Glândulas Salivares/cirurgiaRESUMO
OBJECTIVE: This review attempts to provide a comprehensive, updated overview of the ectopic accessory parotid system (EAPS) from clinical and developmental perspectives and investigates its eligibility to be included in the oculo-auriculo-vertebral spectrum (OAVS). REVIEW METHODS: Results of the keyword-based search in the PubMed/MEDLINE, Google Scholar, LILACS, and Cochrane Library were subjected to the given inclusion and exclusion criteria that corroborated with the definition of EAPS. Eleven records were shortlisted, their full texts studied and references cross-checked. Finally, 10 articles collectively describing 16 patients were considered for review. RESULTS: The average age of presentation was 8.33 years, with 44% of the patients aged below 5 years. Boys were affected 1.67 times more. The cheek fistula was always unilateral, with marginal left predilection. About 94% of the patients were of East Asian descent, chiefly from China and India. Thirteen children had preauricular appendages, mostly ipsilateral, with occasional ipsilateral mandibular hypoplasia (25%). The ectopic parotid was anterolateral to the masseter, lateral to buccinator, and inferior to the Stensen duct. Complete surgical removal of the EAPS (intraoral approach) or transposing the fistula into the oral cavity formed the mainstay of treatment. CONCLUSION: The EAPS is a rare craniofacial anomaly presenting with a saliva-draining cheek fistula, associated with ipsilateral preauricular appendages (microtia) and occasional mandibular hypoplasia. Speculative developmental theories suggest dysmorphogenesis of the first two pharyngeal arches, clinically and embryologically relating it with OAVS. This review summarizes the clinical aspects, and establishes isolated EAPS as a mild but discrete phenotype of OAVS irrespective of the presence of other congenital stigmata. Laryngoscope, 127:1351-1360, 2017.
Assuntos
Bochecha/anormalidades , Coristoma/patologia , Anormalidades Craniofaciais/patologia , Glândula Parótida , Fístula das Glândulas Salivares/patologia , Criança , Pré-Escolar , China , Coristoma/congênito , Anormalidades Craniofaciais/complicações , Feminino , Humanos , Índia , Masculino , Ductos Salivares/patologia , Fístula das Glândulas Salivares/congênitoRESUMO
Cyst and fistulas of the gills grooves and thyro-glossal tracts are well documented. On the contrary, congenital neck salivary fistulas are uncommon.
Assuntos
Fístula Cutânea/diagnóstico , Pescoço/anormalidades , Fístula das Glândulas Salivares/diagnóstico , Adulto , Fístula Cutânea/congênito , Fístula Cutânea/cirurgia , Humanos , Masculino , Pescoço/cirurgia , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/cirurgia , Doenças da Glândula Submandibular/congênito , Doenças da Glândula Submandibular/diagnóstico , Doenças da Glândula Submandibular/cirurgiaRESUMO
The author reports a case of congenital fistula from an accessory parotid gland and describes its diagnosis and treatment. The patient was referred to the author's clinic for evaluation of a continuous serous discharge from a small orifice in the left cheek near the angle of the mouth. A left preauricular appendix was also noted. Fistulography detected an aberrant duct leading to an accessory parotid gland. The main parotid gland and its duct were normal. The anomalous duct was dissected in continuity with a small ellipse of skin and sutured to the buccal mucosa. The patient's recovery was uneventful. The author also discusses the embryologic origin of this rare anomaly.
Assuntos
Fístula Cutânea/diagnóstico , Glândula Parótida/anormalidades , Fístula das Glândulas Salivares/diagnóstico , Adolescente , Fístula Cutânea/congênito , Fístula Cutânea/cirurgia , Humanos , Masculino , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/cirurgiaRESUMO
OBJECTIVES: We report two cases of congenital salivary fistula of an accessory parotid gland, and we discuss its occurrence in Goldenhar syndrome. METHODS: Two teenagers complained of a congenital cheek fistula with constant salivary discharge. Computed tomography fistulography and sialography were performed. The diagnosis of Goldenhar syndrome was established based on clinical and imaging findings. Previously reported cases are reviewed and the clinical and radiological features summarised. RESULTS: In these two patients, a salivary fistula of an accessory parotid gland was demonstrated on computed tomography fistulography, and did not communicate with Stensen's duct. Deformity of Stensen's duct and hypoplasia of the ipsilateral mandibular ramus were present. Tragal appendices have frequently been reported in such cases. CONCLUSION: A congenital cheek salivary fistula of an accessory parotid gland should be considered indicative of Goldenhar syndrome.
Assuntos
Coristoma/diagnóstico por imagem , Fístula Cutânea/diagnóstico por imagem , Síndrome de Goldenhar/diagnóstico por imagem , Doenças Parotídeas/diagnóstico por imagem , Glândula Parótida/patologia , Fístula das Glândulas Salivares/diagnóstico por imagem , Adolescente , Bochecha , Criança , Coristoma/cirurgia , Fístula Cutânea/congênito , Fístula Cutânea/cirurgia , Assimetria Facial/congênito , Feminino , Humanos , Masculino , Doenças Parotídeas/congênito , Doenças Parotídeas/cirurgia , Saliva , Ductos Salivares/anormalidades , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/cirurgia , Sialografia , Tomografia Computadorizada por Raios X/métodosRESUMO
A rare case of congenital salivary gland fistula is reported. A 3-year-old girl presented with clear discharge from a dimple on the left cheek. An ectopic salivary gland fistula was unexpectedly diagnosed during operation. This is the first case of congenital salivary fistula draining from a minor salivary gland to a cutaneous pit. We completely excised the lesion, and the patient remains complication free.
Assuntos
Fístula Cutânea/congênito , Fístula das Glândulas Salivares/congênito , Glândulas Salivares Menores/cirurgia , Bochecha , Pré-Escolar , Fístula Cutânea/diagnóstico por imagem , Fístula Cutânea/patologia , Fístula Cutânea/cirurgia , Feminino , Humanos , Fístula das Glândulas Salivares/diagnóstico por imagem , Fístula das Glândulas Salivares/patologia , Fístula das Glândulas Salivares/cirurgia , Glândulas Salivares Menores/diagnóstico por imagem , Glândulas Salivares Menores/patologia , UltrassonografiaRESUMO
OBJECTIVE: We present an extremely rare case of a 44-year-old woman with right gustatory otorrhoea and otalgia. CASE REPORT: The patient had been initially treated for otitis externa after Pseudomonas aeruginosa was grown from a microbiological swab. The otorrhoea fluid was collected and tested positive for amylase. Sialography and computed tomography imaging of the temporal bone confirmed a sialo-aural fistula from the right parotid gland to the bony external acoustic meatus. The defect was consistent with a patent foramen of Huschke. The fistula was identified surgically via a superficial parotidectomy approach, after contrast injection of Bonney's blue dye into the parotid duct, and then ligated and divided. The patient had immediate and sustained resolution of her otorrhoea. CONCLUSIONS: Sialo-aural fistulae are extremely rare, and usually arise as a complication of surgery or as an acquired disease process. To date, only four cases have been reported. This case demonstrates the use of sensitive investigation involving sialography and computed tomography, as well as successful surgical management, with complete resolution of symptoms.
Assuntos
Fístula Cutânea/congênito , Glândula Parótida/anormalidades , Ductos Salivares/anormalidades , Fístula das Glândulas Salivares/congênito , Adulto , Fístula Cutânea/cirurgia , Feminino , Humanos , Fístula das Glândulas Salivares/cirurgia , Sialografia/métodos , Resultado do TratamentoRESUMO
As fístulas salivares de origem congênita são má formações de incidência rara. Devem ser diferenciadas de fístulas de 2° arco branquial, pelas características clínicas distintas, como a ausência de episódios de infecção e drenagem abrupta, que aumenta durante a alimentação. Dúvidas ainda existem com relação à sua etiologia. As hipóteses existentes cogitam a migração anormal de tecidos embrionários e a heteroplasia de células ectodérmicas, que regridiriam no processo de diferenciação celular. A fistulografia da lesão mostra fundo de saco arboriforme e ajuda no diagnóstico diferencial da lesão. O tratamento é cirúrgico, com ressecção do trajeto da lesão e da glândula que a originou. Apresentamos três casos de fístulas salivares congênitas.
Salivary gland fistulas are rare malformations and should be differentiate from others draining sinuses pathologies, especially from the second branchial cleft sinuses. Precise pathogenesis is not fully understood. Clinically, the episodes of drainage are usually associated with a sense of fullness in the affected area and the amount of drainage usually increases during eating or mastication. A preoperative sinugram is helpful. The treatment is its excision. We present three cases of unusual salivary gland fistula.
Assuntos
Humanos , Masculino , Criança , Adolescente , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/cirurgia , Fístula das Glândulas Salivares/diagnósticoRESUMO
UNLABELLED: We report the imaging findings in a rare case of an accessory parotid gland fistula. MATERIAL AND METHODS: An eight-year-old boy was presented with complaints of serous discharge from his left cheek since birth. As part of the radiological investigation, magnetic resonance imaging, computed tomography sialography with fistulography, and digital sialography with fistulography were performed. RESULTS: Magnetic resonance imaging demonstrated the exact location of an accessory parotid gland but failed to demonstrate the accessory duct. The presence of an accessory gland was well delineated on computed tomography fistulography and computed tomography sialography. Fistulography revealed a small accessory parotid duct and gland. No communication between the ductal systems of both glands was demonstrated. CONCLUSIONS: In such cases, pre-operative imaging (with sialography, magnetic resonance sialography and computed tomography sialography with fistulography) is helpful for exact delineation of the ductal anatomy. To the best of our knowledge, only four previous cases of congenital accessory parotid gland fistula have been reported in the English literature.
Assuntos
Fístula Cutânea/congênito , Glândula Parótida/anormalidades , Ductos Salivares/anormalidades , Fístula das Glândulas Salivares/congênito , Criança , Fístula Cutânea/cirurgia , Humanos , Masculino , Fístula das Glândulas Salivares/cirurgia , Sialografia/métodos , Tomografia Computadorizada por Raios XAssuntos
Meato Acústico Externo/anormalidades , Otite Média com Derrame/etiologia , Doenças Parotídeas/congênito , Fístula das Glândulas Salivares/congênito , Adulto , Cistos/etiologia , Cistos/cirurgia , Meato Acústico Externo/cirurgia , Feminino , Humanos , Masculino , Otite Média com Derrame/cirurgia , Doenças Parotídeas/complicações , Doenças Parotídeas/cirurgia , Parotidite/etiologia , Parotidite/cirurgia , Fístula das Glândulas Salivares/complicações , Fístula das Glândulas Salivares/cirurgiaRESUMO
Three cases of unusual cervical fistulae are presented with a review of the literature to caution against labelling all lateral cervical fistulae as simple branchial fistulae or midline ones as dermoid cysts.
Assuntos
Coristoma , Músculos do Pescoço , Fístula das Glândulas Salivares/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Doenças das Glândulas Salivares/diagnóstico , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/embriologia , Fístula das Glândulas Salivares/patologia , Fístula das Glândulas Salivares/cirurgia , Resultado do TratamentoRESUMO
This report is about a seven-year-old male, who came to the dental clinic for routine treatment and congenital labial fistulas was found. The clinical case is described as well as the most outstanding points of this clinical entity.
Assuntos
Doenças Labiais/congênito , Lábio/anormalidades , Fístula Bucal/congênito , Criança , Humanos , Masculino , Fístula das Glândulas Salivares/congênito , SíndromeRESUMO
OBJECTIVE: This study was conducted to evaluate the relationship between fistulae of the lower lip and cleft lip and/or palate in patients with Van der Woude syndrome. METHODS: The medical records of 11,000 patients with cleft lip and/or palate registered at the Cleft Lip-Palate Research and Rehabilitation Hospital, University of São Paulo, Bauru were reviewed. Of these patients, 133 (1.2%) presented with Van der Woude syndrome. RESULTS: Of the 133 patients, 88 (66.2%) exhibited full clefts, 22 (16.5%) only cleft lip, and 23 (17.3%) only cleft palate. The lower-lip fistulae observed in these 133 patients were bilateral symmetric in 66 (49.7%), bilateral asymmetric in 42 (31.6%), microform in 19 (14.3%), median in 5 (3.8%), and unilateral in 1 (0.7%). CONCLUSION: This population sample appears to exhibit the previously published tendency for bilateral, unilateral, or mixed-type congenital fistulae to be associated with cleft lip with or without cleft palate, while so-called microforms or conic elevations are almost exclusively associated with cleft palate.
Assuntos
Fenda Labial , Fissura Palatina , Fístula/congênito , Doenças Labiais/congênito , Criança , Feminino , Humanos , Masculino , Fístula das Glândulas Salivares/congênito , SíndromeRESUMO
We report a case of congenital fistula from ectopic accessory parotid gland to the cheek demonstrated by CT sialography and CT fistulography. The right parotid gland was abnormally located lateral to masseter muscle. The fistula was arising from an ectopic accessory parotid gland with ectopic duct positioned anterior to masseter muscle. CT sialography and CT fistulography were very helpful in the diagnosis and surgical planning.
Assuntos
Bochecha , Coristoma/diagnóstico por imagem , Neoplasias Faciais/congênito , Glândula Parótida , Fístula das Glândulas Salivares/congênito , Sialografia , Tomografia Computadorizada por Raios X , Bochecha/diagnóstico por imagem , Pré-Escolar , Diagnóstico Diferencial , Neoplasias Faciais/diagnóstico por imagem , Feminino , Humanos , Fístula das Glândulas Salivares/diagnóstico por imagemRESUMO
A female patient with a preotic fistula caused by a defect in the development of the first branchial arch is described. Repeated surgeries for lateral fistula of the neck brought no success. The pathogenesis of the defect and difficulties in its diagnosis are discussed; the authors claim that fistulography with contrast agents may be effective. Histologic verification is needed in all the cases.
Assuntos
Branquioma/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Doenças Parotídeas/diagnóstico , Fístula das Glândulas Salivares/diagnóstico , Adolescente , Branquioma/congênito , Branquioma/cirurgia , Feminino , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Doenças Parotídeas/congênito , Doenças Parotídeas/cirurgia , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Fístula das Glândulas Salivares/congênito , Fístula das Glândulas Salivares/cirurgiaRESUMO
Congenital salivary fistulae are rare and may be associated with abnormalities of the branchial apparatus or arise from aberrant or accessory salivary tissue. Previous case reports have documented cutaneous fistulae. We report a case of a salivary fistula between the submandibular gland and the oropharynx and discuss a possible embryological basis for the abnormality.
Assuntos
Fístula/diagnóstico por imagem , Doenças Faríngeas/diagnóstico por imagem , Fístula das Glândulas Salivares/congênito , Doenças da Glândula Submandibular/congênito , Adulto , Feminino , Humanos , Orofaringe/diagnóstico por imagem , Radiografia , Fístula das Glândulas Salivares/diagnóstico por imagem , Doenças da Glândula Submandibular/diagnóstico por imagemRESUMO
A rare case of an auxiliary major salivary gland in the parotid region with an external fistula is reported. Clinical findings and management are described, and relevant embryology and etiology are discussed.
Assuntos
Doenças Parotídeas/congênito , Glândula Parótida/anormalidades , Fístula das Glândulas Salivares/congênito , Adolescente , Feminino , HumanosRESUMO
Labial pits are usually described as blind epidermal invaginations of lip mucosa with occasional drainage of minor salivary gland secretions. A case of an aberrant parotid duct in communication with both a unilateral, commissural labial pit and an interposed salivary cyst is presented. A 7-year-old boy who had experienced lifelong clear drainage from a congenital pit at his right oral commissure developed fever, pain, and a submucosal mass of the right cheek over a 6-week period. A preoperative sialogram through the pit demonstrated a communication between the oral commissure fistula, an intervening salivary cyst, and a proximal tract from the cyst to the parotid gland. An en bloc resection of the pit, fistula tract, and cyst was performed through a transoral approach. The dissection was medial to the buccinator muscle. There has been no recurrence of the cyst after 1 year follow-up. A description of labial pits and parotid duct anomalies is presented; however, to our knowledge, this combination of anomalies has not been previously described.