Sialorrhoea due to development of salivary fistula after carotid endarterectomy. Diagnostics and treatment. A clinical case

Abstract

Wound complications after carotid endarterectomy are rare ones. One of them is the formation of a salivary fistula due to the damage of the submandibular salivary gland. A factor that increases the likelihood of the damage of the salivary gland is a high bifurcation of the carotid arteries. This article presents a case of conservative treatment of the salivary fistula after carotid endarterectomy. Modern diagnostic methods, consisting in biochemical analysis of the secreted fluid for alpha-amylase, contribute to rapid diagnostics. Treatment with the anticholinergic drug 0.1 % atropine sulfate, 6 drops under the tongue half an hour before each meal, has proved its efficiency. In conjunction with medical treatment, it is necessary to ensure an adequate outflow of saliva from the wound to prevent the formation of salivoma and compression of the airways. Long-term conservative therapy makes it possible to achieve a complete cessation of sialorrhea through a salivary fistula and to eliminate the need for surgical treatment.

Keywords

sialocele / salivoma / salivary fistula / sialorrhea / complications of carotid endarterectomy

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