Onabotulinum toxin injection for parotid fistula treatment in a case of recurrent parotitis complicated with abscess formation

Salivary fistula is an epithelial track between the salivary gland or its duct and the skin, through which saliva is discharged. Parotid fistula is considered one of the most serious postoperative complications after parotid gland surgery and occurs also after accidental trauma [1,2]. In adults, the most common cause of parotid fistulas is parotidectomy. The literature has showed that injury to the parotid gland after a parotidectomy is usually a glandular injury rather than a ductal injury [1,3,4]. Salivary gland fistulas are more unusual in children and can be congenital or secondary to trauma [5]. Salivary congenital fistulas are more often derived from minor salivary glands or accessory parotid glands [6]. More often, as in adults, parotid fistulas in children are secondary to trauma, occurring mainly after surgical procedures. It was reported by Wax and their team that postparotidectomy fistula rate is about 14% [7]. Furthermore, another study done by Laskawi et al. documented 4% parotid fistula after parotidectomy in the treatment of parotid pleomorphic adenomas [8].