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Salivary fistulas following parotidectomy: follow-up results

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GÁL Břetislav HLOŽKOVÁ Tereza KOSTŘICA Rom HLOŽEK Jiří SMILEK Pavel HANÁK Jan VESELÝ Miroslav

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Fakulta / Pracoviště MU

Lékařská fakulta

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Popis Background: Salivary fistulas are a well-known complication that can occur after parotid gland surgery. The fistulas present with repeated leakage of saliva from the surgical wound, particularly after meals. Recently, interposing barriers between the overlying skin flap and the parotid bed, such as the sternocleidomastoid muscle (SCM) flap, have been used to prevent this condition. Purpose: The purpose of this study was demonstrate a technique of SCM flap following partial and total parotidectomy and evaluate the impact of using this flap on incidence of salivary fistula. Material and Methods: This retrospective study included 155 patients who underwent partial and total parotidectomy for benign tumors since January 2007 to December 2011 at the Department of Otorhinolaryngology and Head and Neck Surgery St. Anne's University Hospital Brno. The series of patients was divided into two groups. One group had an SCM flap recontruction (n=35), and the other group did not (n=120). Results: Overal rate of salivary fistulas was 19/155 (12,3%) and the average duration of salivocutaneous flow was 25 days in our study. The incidence of salivary fistulas were significantly lower in SCM flap group 2/35 (5,7%) compared with the no-flap group 16/120 (13,3%). Duration of salivary laekage was similar in both groups 26 vs 25 days (p < 0.05). No statistically significant diference was found between incidence of salivary fistulas and extent of the surgery, in partial parotidectomy group 15/129 (11,6%), in total parotidectomy group 3/26 (11,5%); p < 0.05. Conclusion: The SCM flap is an efficient method for preventing salivary fistula following parotidectomy.