Parotid duct anastomosis with an epidural catheter as a stent and evaluation of postoperative gland function / 口腔疾病防治

Objective @#To investigate the feasibility of epidural catheters in parotid gland duct anastomosis and the function of the affected side gland after parotid gland duct anastomosis. @* Methods@# Thirteen patients who were treated in the Department of Oral and Maxillofacial Surgery of Xuzhou Central Hospital using an epidural catheter as the scaffold for parotid gland catheter anastomosis were enrolled from Jan. 2019 to June 2021. The swelling, salivary fistula and catheter patency in the parotid gland area were evaluated two weeks after the operation. 99mTcO4- single photon emission computed tomography (SPECT) was used for quantitative detection of salivary gland secretion function@*Results@# Thirteen patients had no swelling or salivary fistula in the parotid gland area of the affected side two weeks after the operation, and the catheter secretion was unobstructed. There was no significant difference in the uptake rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = -0.859, P = 0.399), and there was no significant difference in the excretion rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = 0.693, P = 0.495). The parotid gland excretion function of the affected side was excellent three months after the operation.@*Conclusion @#Parotid duct anastomosis with an epidural catheter as the stent has good feasibility, and parotid gland secretion function recovers well after the operation, which is worthy of clinical application.

Modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction / 华西口腔医学杂志

OBJECTIVES@#This study aimed to analyze the application value of a modified tragus edge incision and transmasseteric anteroparotid approach to condyle reconstruction.@*METHODS@#Condyle reconstruction was performed in 16 patients (9 females and 7 males) with modified tragus edge incision and transmasseteric anteroparotid approach. After regular follow-up, the function of condyle reconstruction was evaluated by clinical indicators, such as parotid salivary fistula, facial nerve function, mouth opening, occlusal relationship, and facial scar. The morphology of rib graft rib cartilage was evaluated by imaging indicators, such as panoramic radiography, CT, and three-dimensional CT image reconstruction.@*RESULTS@#At 6-36 months postoperative follow-up, all patients had good recovery of facial appearance, concealed incisional scar, no parotid salivary fistula, good mouth opening, and occlusion. One case had temporary facial paralysis and recovered after treatment. Radiographic evaluation further showed that costochondral graft survived in normal anatomic locations.@*CONCLUSIONS@#The modified tragus edge incision and transmasseteric anteroparotid approach can effectively reduce parotid salivary fistula and facial nerve injury in condylar reconstruction. The surgical field was clearly exposed, and the incision scar was concealed without increasing the incidence of other complications. Thus, this approach is worthy of clinical promotion.

Application of Delayed Surgical Managements in Patients with Stensen's Duct Injury / 华中科技大学学报（医学）（英德文版）

The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries.Nine patients subjected to parotid gland and duct injuries with 1-to 3-month treatment delay were retrospectively evaluated with special reference of etiology,past medical history,and injury location.Conservative treatment,microsurgical anastomosis,and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury,time of repair and procedures.Assistant treatment as pressure dressing was adopted thereafter.All patients experienced an uneventful recovery at the time of finalizing the study.Two patients received Stensen's duct ligation,5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas,and no re-occurrence was found.Facial paralysis occurred after surgery in 4 patients,and 3 of them recovered after the nerve nutrition treatment.Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.

Application of Delayed Surgical Managements in Patients with Stensen's Duct Injury / 华中科技大学学报（医学）（英德文版）

The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries.Nine patients subjected to parotid gland and duct injuries with 1-to 3-month treatment delay were retrospectively evaluated with special reference of etiology,past medical history,and injury location.Conservative treatment,microsurgical anastomosis,and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury,time of repair and procedures.Assistant treatment as pressure dressing was adopted thereafter.All patients experienced an uneventful recovery at the time of finalizing the study.Two patients received Stensen's duct ligation,5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas,and no re-occurrence was found.Facial paralysis occurred after surgery in 4 patients,and 3 of them recovered after the nerve nutrition treatment.Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.

Application and effect of high quality nursing in salivary fistula after parotid gland tumor operation / 中国实用护理杂志

Objective@#To explore the effect of high quality nursing on the salivary fistula of the patients after parotid tumor operation.@*Methods@#August 2015-2017 June, 60 cases of parotid tumor were selected in our hospital for parotid tumor surgery. According to the nursing intervention methods, the observation group and the control group were divided into the observation group and the control group (n=30). The control group (n=30) was given the routine nursing. The nursing satisfaction of the two groups and the incidence of depression and anxiety before and after nursing. as well as the incidence of postoperative salivary fistula were observed.@*Results@#The total satisfaction degree of nursing in the observation group was 96.67% (29/30), the control group was 76.67% (23/30). The total satisfaction degree of nursing in the observation group was significantly higher than that of the control group, and the difference was statistically significant (χ2=17.311 4, P<0.01). After nursing, the Self-rating Depression Scale (SDS) score and the Self-rating Anxiety Scale (SAS) score of the observation group were 10.35±1.65, 13.56±1.44, which were significantly lower than 21.51±2.49, 30.42±3.58 in the control group, and the difference was statistically significant (t=20.463 5, 23.931 6, P<0.01). After nursing, physical function, cognitive function, emotional function, social function and role function score of observation group were 75.2±6.8, 70.2±7.0, 75.6±5.0, 76.8±7.3, 76.4±7.0, which were significantly higher than 60.7±6.7, 51.6±7.3, 60.8±6.2, 61.3±7.4, 61.1±7.4 of control group, the difference was statistically significant (t=8.167 3-10.177 5, P<0.0). The incidence of salivary fistula in the observation group was 10.00% (3/30) which was significantly lower than 43.33 (13/30) of the control group, and the difference was statistically significant (χ2=28.404 5, P<0.05).@*Conclusion@#The application of high quality nursing in postoperative salivary fistula of parotid tumor patients is significant. It can effectively improve the patients′ unhealthy psychological emotion, improve their quality of life and reduce the incidence of complications, which is worthy of clinical promotion.