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Reconstruction of a traumatically transected Stensen's duct using facial vein graft.

Awana M, Arora SS, Arora S, Hansraj V - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Traumatic injuries to the lower third of the face can result in damage to various vital structures.We report a case of traumatically avulsed Stenson's duct and facial vein wherein the vein was used as a free graft to lengthen the duct.The paper highlights the need on how best to utilise the locally available and viable tissues as free grafts.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India.

ABSTRACT
Traumatic injuries to the lower third of the face can result in damage to various vital structures. We report a case of traumatically avulsed Stenson's duct and facial vein wherein the vein was used as a free graft to lengthen the duct. The paper highlights the need on how best to utilise the locally available and viable tissues as free grafts.

No MeSH data available.


Related in: MedlinePlus

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Mentions: A 40-year-old male patient reported with pain and swelling on the right side of the face. He complained of a discharge oozing from a sutured laceration in the right cheek region. There was a history of trauma to the right side of the face 6 days back from a machine used in farming. The resulting wound was sutured at a primary health center. The wound measuring about 5 cm extended from the corner of the mouth to roughly 2 cm anterior to the pinna of the right ear. Following clinical and biochemical examination of the discharge a diagnosis of right parotid duct transection and concomitant salivary ooze was reached. Facial nerve function was found to be intact. Under general anesthesia, surgical exploration of the wound revealed a transected parotid duct over the masseter muscle. The patency of the proximal portion of the duct was maintained by cannulation. The distal part of the duct could not be traced even after attempts were made by injecting normal saline through the papilla. Transected facial vein was found alongside the duct. It was decided to dissect the facial vein and use it as a free vein graft for lengthening the proximal segment of the duct [Figures 1 and 2]. Venous graft was anastomosed with the parotid duct with 10-0 nylon using a surgical microscope [Figures 3 and 4]. An 18-gauge intracath was used as a stent to support the graft [Figures 5 and 6]. This was pulled intraorally and transfixed with 3-0 silk [Figures 7 and 8]. A suction drain was placed and the wound was closed in layers [Figure 9]. The catheter was removed after 3 weeks. Sialography could not be performed in this case, as the patient did not give consent for it. The patient was followed up for a period of 1-year and no postoperative complications were noticed.


Reconstruction of a traumatically transected Stensen's duct using facial vein graft.

Awana M, Arora SS, Arora S, Hansraj V - Ann Maxillofac Surg (2015 Jan-Jun)

Closure
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555959&req=5

Figure 8: Closure
Mentions: A 40-year-old male patient reported with pain and swelling on the right side of the face. He complained of a discharge oozing from a sutured laceration in the right cheek region. There was a history of trauma to the right side of the face 6 days back from a machine used in farming. The resulting wound was sutured at a primary health center. The wound measuring about 5 cm extended from the corner of the mouth to roughly 2 cm anterior to the pinna of the right ear. Following clinical and biochemical examination of the discharge a diagnosis of right parotid duct transection and concomitant salivary ooze was reached. Facial nerve function was found to be intact. Under general anesthesia, surgical exploration of the wound revealed a transected parotid duct over the masseter muscle. The patency of the proximal portion of the duct was maintained by cannulation. The distal part of the duct could not be traced even after attempts were made by injecting normal saline through the papilla. Transected facial vein was found alongside the duct. It was decided to dissect the facial vein and use it as a free vein graft for lengthening the proximal segment of the duct [Figures 1 and 2]. Venous graft was anastomosed with the parotid duct with 10-0 nylon using a surgical microscope [Figures 3 and 4]. An 18-gauge intracath was used as a stent to support the graft [Figures 5 and 6]. This was pulled intraorally and transfixed with 3-0 silk [Figures 7 and 8]. A suction drain was placed and the wound was closed in layers [Figure 9]. The catheter was removed after 3 weeks. Sialography could not be performed in this case, as the patient did not give consent for it. The patient was followed up for a period of 1-year and no postoperative complications were noticed.

Bottom Line: Traumatic injuries to the lower third of the face can result in damage to various vital structures.We report a case of traumatically avulsed Stenson's duct and facial vein wherein the vein was used as a free graft to lengthen the duct.The paper highlights the need on how best to utilise the locally available and viable tissues as free grafts.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India.

ABSTRACT
Traumatic injuries to the lower third of the face can result in damage to various vital structures. We report a case of traumatically avulsed Stenson's duct and facial vein wherein the vein was used as a free graft to lengthen the duct. The paper highlights the need on how best to utilise the locally available and viable tissues as free grafts.

No MeSH data available.


Related in: MedlinePlus