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KMID : 0903220110120020129
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Journal of the Korean Cleft Palate-Craniofacial Association
2011 Volume.12 No. 2 p.129 ~ p.131
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Treatment of Parotid Fistula with Type A Botulinum Toxin: A Case Report
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Lee Sang-Yeul
Kim Sam-Soo
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Abstract
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Purpose: The purpose of this report is to present a case of persistent parotid fistula treated successfully with preoperative botulinum toxin type A injection into the parotid parenchyma, followed by fistulectomy.
Methods: A 72-year-old female patient presented to the hospital with a 5-month history of clear, watery discharge from a tiny opening on the left cheek, which increased during food intake. A chemistry test of the fluid revealed an high amylase level. An ultrasonography of left parotid gland showed a 1.13×0.6cm sized fistula. After demarcating the left parotid gland with assistance of ultrasonography, a total 40 units of botulinum toxin type A(Botox, Allergan, Irvine, CA) was injected into 4 subdivisions of the left parotid gland. The clear serous discharge ceased completely on the 5th day after botulinum toxin injection. On the 7th day, a fistulectomy was performed under the local anesthesia.
Results: The parotid fistula healed completely without complications. During the 6-month follow up period, there was no discharge from the cheek.
Conclusion: On the basis of our experience with type A botulinum toxin as a local anticholinergic agent in treating parotid fistula, preoperative botulinum toxin A injection seems to be very useful to prevent recurrence after fistulectomy.
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KEYWORD
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Botulinum toxin, Parotid fistula, Parotid abscess
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