The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on this procedure.

 As part of the NICE's work programme, the current guidance was considered for review in May 2009 but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.


Superficial parotid gland surgery may be complicated in about 10%–15% of cases by the development of an abnormal tract (sinus) between the remnants of the parotid gland and the outer surface of the cheek The sinus may have unwanted cosmetic effects, cause excoriation of the cheek and may also cause chronic leakage of saliva.

This procedure involves injecting a solution of lipiodiol and cyanoacrylate via the sinus into the parotid gland, sealing the sinus. The procedure may be repeated.

Other interventions for parotid sinus include watchful waiting, bandaging, radiotherapy, local denervation of the gland or excision of the deep parotid lobe. Excision of the deep lobe risks damaging branches of the facial nerve. 

Coding recommendations

F48.5 Injection of therapeutic substance into salivary gland

Z26.1 Parotid gland