2 The procedure

2.1 Indications

2.1.1 Superficial parotid gland surgery may be complicated in about 10–15% of patients 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, and may cause chronic leakage of saliva with excoriation of the cheek.

2.1.2 Management of parotid sinuses includes watchful waiting, bandaging, radiotherapy, local denervation of the gland or excision of the deep lobe of the gland.

2.2 Outline of the procedure

2.2.1 A solution of lipiodol and cyanoacrylate is injected via the sinus into the parotid gland, sealing the sinus. If the procedure is unsuccessful and symptoms recur, the procedure can be repeated.

2.3 Efficacy

2.3.1 The evidence was limited to one case report. Although this demonstrated the feasibility of the technique, the report was uncontrolled and did not provide any further information about efficacy and safety. For more details, refer to the 'Sources of evidence' section.

2.3.2 No specialist advice was provided for this procedure. The Advisors who were approached were unaware of the technique.

2.4 Safety

2.4.1 See Section 2.3.1.

2.4.2 No specialist advice was provided for this procedure. The Advisors who were approached were unaware of the technique.

2.5 Other comments

2.5.1 The procedure appears to have been carried out once, on one patient, by one clinician. Anyone considering its use may wish to contact that clinician, Mr AJ Marcus of the Edgware Hospital.

Andrew Dillon
Chief Executive
February 2004