Arch Aesthetic Plast Surg.  2014 Jun;20(2):120-123. 10.14730/aaps.2014.20.2.120.

Treatment of Botulinum Toxin Type A in Parotid Fistula after Face Lifting

• Jung MS
• Lee BH
• Kim JH
• Park SH
• Ahn DK
• Jeong HS
• Suh IS

• KMID: 2134149
• DOI: http://doi.org/10.14730/aaps.2014.20.2.120

Abstract

Botulinum toxin type A has an inhibitory action not only on neuromuscular junctions, but also postganglionic sympathetic and cholinergic autonomic parasympathetic acetylcholine release at the secretary end of the salivary gland. Use of botulinum toxin to treat sialorrhea was first reported in 1997 by Bushara. Parotid duct or gland injuries with parotid fistula are uncommon but troublesome complications of surgical trauma. Here, we report two patients with constant leakage of serous fluid and a swelling cheek after facelift surgery. Each patient underwent an amylase test, starch iodine test, and sialography. After diagnosis of parotid fistula, a total of 50 units botulinum toxin was injected into the parotid gland. Facial bandage, scopolamine, and minimizing temporomandibular joint motion were instructed. Leakage volume decreased gradually, and symptoms subsided within 2 weeks. Neither functional problems nor complications occurred. In conclusion, a parotid fistula after facial surgery can be treated effectively with botulinum toxin; this treatment option should be considered before proceeding with invasive surgical treatment.

Keyword

Botulinum toxin A; Facelift; Fistula; Parotid gland

MeSH Terms

Acetylcholine
Amylases
Bandages
Botulinum Toxins
Botulinum Toxins, Type A*
Cheek
Diagnosis
Fistula*
Humans
Iodine
Neuromuscular Junction
Parotid Gland
Rhytidoplasty*
Salivary Glands
Scopolamine Hydrobromide
Sialography
Sialorrhea
Starch
Temporomandibular Joint
Acetylcholine
Amylases
Botulinum Toxins
Botulinum Toxins, Type A
Iodine
Scopolamine Hydrobromide
Starch