Fistula on sialotomography

Case contributed by Bruno Lorensini
Diagnosis certain

Presentation

Post-operative of hidradenitis in the right maxillary region, presenting with output salivary secretion in the surgical wound.

Patient Data

Age: 50 years
Gender: Male
ct

Fistula between the anterolateral portion of the superficial parotid lobe extending to the skin for about 1.3 cm.

Case Discussion

Conventional sialography and sialotomography are techniques that have lost their use after increasing access to ultrasound and magnetic resonance imaging, especially due to the invasive nature.

In places where there is limited access to MRI, conventional sialography and sialotomography are valid options.

Especially in the case described above, where there was suspicion of fistula, the sialotomography clearly demonstrated the contrast on the parotid duct (Stensen's duct) and fistula extending to the skin.  CT allows a good evaluation of fistula topography, the parotid parenchyma and intraparotid ducts and the deep portions of the parotid, facilitating a future surgical procedure.

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