gms | German Medical Science

Introduction: Emerging trend toward low-morbidity surgery for the treatment of benign parotid tumors has been recognized. Although techniques involving less then superficial parotidectomy have lower incidence of postoperative facial palsy and cosmetic deformity, the rate of sialocele and salivary fistula still remains relatively high. The aim of this study is to determine efficiency of perioperative transdermal scopolamine in reducing occurrence of postparotidectomy salivary fistula.

Methods: A retrospective analysis of 577 consecutive parotidectomies for parotid tumors in our department between 2011 and 2014 was performed. Cases involving parapharyngeal tumor masses and clinically malignant involvement of the parotid gland were excluded. Two groups were assessed based on perioperative treatment with transdermal scopolamine patch. The incidence of postoperative salivary fistula according to the extend of the surgery was studied and appropriate management of the fistula was decribed.

Results: The overall rate of salivary fistula in our study was 10.05%. Salivary fistula was recorded in 48 cases without perioperative scopolamine (48/308, 15.58%) and in 10 cases receiving scopolamine (10/269, 3.72%, P<0.05). Complications related to the use of scopolamine were found in 46 cases (46/317, 14.5%) and were limited to mild adverse effects.

Conclusion: Salivary fistula is common and unpleasant complication of less extensive parotid surgery. Many different methods in the literature have been proposed for the treatment of postparotidectomy salivary fistula and none for its prevention. This study demonstrates significant reduction of postoperative complications related to the use scopolamine in a perioperative setting and therefore, this preventive measure could be recommended.

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