Management of Post-Rhytidectomy Sialocele

Abstract

Introduction: Inadvertent damage to the parotid gland parenchyma or ductal drainage system is a rare yet devastating complication of cervicofacial rhytidectomy. Here we describe the management of such a case. Materials and Methods: A 66-year-old woman underwent uneventful rhytidectomy and presented postoperatively with a facial sialocele. Pressure dressings, antibiotics, and serial aspirations were the initial measures used. As the leakage was recalcitrant, botulinum toxin A was injected locally and both transdermal and oral anticholinergics were prescribed. Results: After a steady decrease in the volume of fluid that accumulated, the sialocele resolved on postoperative day 44. After rhytidectomy, damage to the parotid gland can lead to leakage of saliva in the form of a sialocele or a salivary fistula. Discussion: Management options include pressure dressings, drain placement, serial aspirations, anticholinergics, chemical denervation, or parotidectomy. As the drainage may persist for a considerable duration, good communication between the patient and the physician is paramount.