Oral and maxillofacial surgery.
- Acute postoperative parotitis:
- Abscess incision (incision into an encapsulated pus cavity) and capsule splitting if necessary for purulent parotitis (parotid gland inflammation), otherwise irreversible damage to the gland parenchyma due to pressure within the parotid capsule
- If necessary, surgical opening of the parotid lodge and subsequent drainage.
- Surgical removal of an outflow obstruction
- Intraductal (” affecting the excretory duct”), extraglandular (“outside the gland”):
- intraductal manipulation
- If necessary, massage out small stones near the papilla possible
- interventional sialendoscopy
- Endoscopic removal of small stones
- Balloon dilatation – dilatation of a stenosed ductal segment using a liquid- or air-fillable balloon catheter.
- Duct slitting
- In case of stone in Wharton’s duct (common excretory duct of the submandibular gland and sublingual gland)
- Complications: Damage to the lingual nerve
- In the case of prepapillary stone in the parotid duct (stenon duct of the parotid gland).
- In case of stone in Wharton’s duct (common excretory duct of the submandibular gland and sublingual gland)
- intraductal manipulation
- Intraductal (” affecting the excretory duct”), extraglandular (“outside the gland”):
- Sialadenectomy (synonyms: sialectomy; extirpation of a salivary gland; surgical removal of a salivary gland).
- Parotidectomy (surgical removal of the parotid gland).
- In cases of scarring due to recurrent (recurrent) purulent exacerbations (marked worsening of the clinical picture) of chronic parotitis.
- Parotidectomy in the subacute or better in the chronic stage.
- In case of stone location behind the Masseter’s kink of the parotid duct (Stenon’s duct).
- Parotidectomy (surgical removal of the parotid gland) in Sjögren’s syndrome only if extreme swelling conditions or malignant (malignant) development (lymphoma; non-Hodgkin’s lymphoma) require a surgical procedure.
- Complications:
- Facial nerve paresis
- Temporary (intermittent)
- Permanent permanent
- Frey syndrome
- Gustatory (“affecting the sense of taste“).
- Sweating
- Facial nerve paresis
- Extirpation of a Küttner tumor (chronic recurrent sialadenitis of the submandibular gland).
- Complications: Endangerment of the lingual nerve, marginal mandibular ramus of the facial nerve, and hypoglossal nerve.
- Extracorporeal shock wave lithotripsy (EWSL): in selected cases of sialolithiasis (salivary stones), removal of sialoliths can be achieved without surgery by stone fragmentation with shock waves. The sand-like fragments are flushed out in the following days, assisted by the administration of sialagoga (medications that help saliva formation) and glandular massages.Contraindications:
- Acute purulent sialadenitis
- Stenosis (narrowing) of the excretory ducts
