What Is a Traumatic Salivary Duct Injury?

The parotid gland, the largest of the salivary glands, is located in the cheek and releases saliva into the mouth through a long channel known as the parotid duct (or Stensen's duct). A serious injury to the cheek—such as from trauma or a violent incident—can sever this duct. When that occurs, saliva is unable to flow into the mouth and instead leaks into the surrounding tissue, leading to a painful fluid buildup called a sialocele. In some cases, it may even escape through the skin, forming a persistent drainage path known as a salivary fistula. Timely and skilled surgical repair is essential to restore proper saliva flow and avoid these potentially serious complications.

Is a Specialist Evaluation for Duct Injury Right for Me?

A specialist evaluation and repair is an urgent medical necessity following any deep facial injury. You require immediate specialist attention if you have:

  • A deep laceration or wound to your cheek
  • Experienced significant facial trauma
  • Clear, watery fluid seen leaking from the cheek wound
  • Rapid and tense swelling of the cheek area following the injury
  • Been assessed in an emergency department and advised that a specialist duct repair is needed
  • A concern about potential damage to deeper structures of the face

What Are the Benefits of Immediate Specialist Repair?

Having a traumatic ductal injury repaired by a specialist like Dr. Basheeth is critical for a successful outcome. The benefits include:

  • Prevents chronic complications like a sialocele or fistula
  • Restores the normal pathway of saliva into the mouth
  • Meticulous microsurgical repair for optimal healing
  • Minimizes the risk of long-term infection and inflammation
  • Ensures the best possible cosmetic result for the facial wound
  • Preserves the normal function of your parotid gland
  • Avoids the need for more complex and less successful delayed surgeries
  • Expert management of a complex and delicate facial injury

How Is Specialist Duct Repair Different From Simple Stitches?

A specialist repair is vastly different from simply closing the skin wound. A non-specialist might stitch the skin, inadvertently trapping the leaking saliva underneath and guaranteeing a complication. A specialist repair is a delicate microsurgical procedure. Dr. Basheeth must first meticulously find the two tiny, severed ends of the duct within the wound. Then, using an operating microscope and sutures finer than a human hair, he carefully stitches the duct back together over a tiny, flexible tube called a stent. This stent acts as a scaffold, keeping the duct open while it heals, before being removed a few weeks later.

What Does Recovery After Duct Repair Involve?

Recovery involves the healing of both the internal duct and the external facial wound. The fine stent placed inside the repaired duct will remain in place for several weeks, with one end secured inside your mouth. This is crucial for ensuring the duct heals open. During this time, you will need to take care with your diet and oral hygiene. Once the duct has healed sufficiently, Dr. Basheeth will remove the stent in a simple, quick procedure in the clinic.

Why Choose Dr. Naveed Basheeth:Excellence in Facial Trauma Repair

Dr. Naveed Basheeth is an internationally fellowship-trained ENT and Head and Neck surgeon with extensive experience in managing complex facial trauma, including acute salivary duct injuries. He is highly skilled in the delicate microsurgical techniques required for successful ductal repair, with a primary focus on restoring function and achieving the best possible cosmetic outcome for his patients.

Book your personalized consultation at ENT Central today.

Traumatic Salivary Duct Injury FAQs

What happens if the duct injury is missed and not repaired?

What is the stent made of and is it uncomfortable?

Is there a risk to the nerves in my face?

How soon after the injury does the repair need to happen?

What happens if the duct injury is missed and not repaired?

If the injury is not repaired, the saliva will continue to leak. It will either collect under the skin to form a persistent, painful swelling (sialocele) that often gets infected, or it will create a permanent channel to the skin surface (fistula) with constant saliva dribbling down your cheek. Both are difficult to manage and require much more complex delayed surgery.

What is the stent made of and is it uncomfortable?

The stent is a very fine, soft, and flexible silicone tube. It is placed to keep the repaired duct from scarring shut. While you may be aware of the small tube inside your cheek, it is generally well-tolerated and is not painful. Its role in ensuring a successful repair is essential.

Is there a risk to the nerves in my face?

Yes. The nerves that control your facial movements run very close to the parotid duct. A deep cut that injures the duct can also injure these nerve branches. During the repair, Dr. Basheeth takes extreme care to identify, preserve, and if necessary, repair any injured nerve branches to ensure the best possible functional recovery.

How soon after the injury does the repair need to happen?

The repair should be performed as soon as possible, ideally within the first 24-48 hours after the injury. An acute repair, when the tissue is fresh and the duct ends are easier to find, has a much higher success rate than attempting a delayed repair on scarred, inflamed tissue.

Referral Pathway: We provide online consultations within two weeks of referral for out-of-town residents. Relevant investigations, radiological and laboratory, can be undertaken in the patient's city. Private and outsourced referrals can be sent to: admin@entcentral.co.nz (347) 557-8368.
Contact Us