A case report on role of hypertonic saline solution in management of parotid fistula. (August 2022)

• Record Type: Journal Article
• Authors: Bhattarai, Himal Bikram; Yadav, Rukesh; Shah, Sangam; Uprety, Manish; Subedi, Ayusha; Singh, Prabesh Bikram; Devkota, Anirudra; Panthi, Niranjan
• Is Part Of: Annals of medicine and surgery. Volume 80(2022)
• Publication Date: 2022-08
• Subjects: Parotid -- Fistula -- Hypertonic saline; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104208
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Parotid fistula is an uncommon consequence of surgical or non-surgical trauma to the parotid gland or the area surrounding it. To treat it, a variety of pharmacological medicines and surgical techniques are used, each with their own set of benefits, drawbacks, and patient preferences. Case Presentation: We present the successful care of a young female with post-traumatic parotid fistula using hypertonic saline injections into the parotid substance, which is a simple yet efficient approach of treating this abnormality. Discussion: Thermodynamic and physicochemical calculations suggest that hypertonic saline solutions work to close parotid fistula by causing conformational denaturation of the cell membrane proteins in situ and saline can be diluted to a point where there will be no cellular toxicity. It is advised that temperature of the saline should be raised above body temperature to enhance the fibrosing property of physiologic saline. Conclusion: The use of hypertonic hot saline injections combined with compression dressing is a cost-effective, patient-friendly, and almost complication-free approach of treating parotid fistulas with promising results. Highlights: Parotid fistula is an uncommon consequence of surgical or non-surgical trauma to the parotid gland. The use of hypertonic hot saline injections is a cost-effective treatment.