[Radiotherapy : an option for refractory salivary fistulas]. / Radiatio : Therapieoption bei therapierefraktärer Speichelfistel.

A 45-year-old patient presented with refractory salivary fistula, attributed to multiple surgery and Botulinum toxin, following lateral parotidectomy. He underwent fractionated radiotherapy of the remaining parotid gland including the fistula opening (total dose of 30 Gy) at our clinic. In time, fistula secretion could be inhibited completely. Although the indication for radiotherapy for such fistulas is rare since Botulinum toxin has been in use, it should still be considered in refractory disease courses.

Low-dose radiation therapy for benign salivary disorders.

Two patients, one with a persistent salivary fistula after surgery for a skin tumor overlying the parotid region, and the other with a ranula recurrent after surgery, were treated with low-dose irradiation. Both problems resolved after a total dose of less than 30 Gy, and neither patient experienced xerostomia. In selected patients, low-dose radiation therapy offers a solution to persistent salivary flow refractory to surgical management.

Role of irradiation in the suppression of parotid secretions.

Suppression of salivary flow is of value in the management of salivary fistulae and sialectasia. It may also be beneficial in mentally defective patients and those with neurological palsies lacking control of their salivation. Nine patients were treated by irradiation to the parotid gland to control salivary flow; eight had complete resolution of symptoms and one had partial relief. Irradiation was effective as primary treatment and after failed surgery and/or drug treatment. Low doses were effective and there were no significant acute or long-term side effects. Its use avoids long-term medication and their potential side effects and may reduce the need for surgery.

[Radiotherapy in the prevention of postoperative and traumatic complications]. / Luchevaia terapiia v preduprezhdenii posleoperatsionnykh i ranevykh oslozhenii.

An analysis of the results of radiation therapy of 587 patients with postoperative and traumatic complications has shown that special gamma-therapy used at early time following trauma or surgical intervention, with the first clinical signs of an incipient inflammatory process (the so-called "anticipating" irradiation), makes it possible to avoid the development of serious postoperative, post-traumatic complications: wound suppuration, fistulas, secondary parotitis, postamputation pain syndrome, "needle" osteomyelitis, keloid cicatrix, skin graft rejection, etc. In the authors' opinion, this promising trend in radiotherapy of nontumorous diseases is worth a wider using in clinical practice.