Application of Delayed Surgical Managements in Patients with Stensen＇s Duct Injury

The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.

Evaluation of Surgical Complications of Mandibulectomy

Mandibulectomy is a surgery that leads to heavy aesthetic and functional sequelae. Surgical complications have been noted but have not yet been evaluated. The aim of this study was to evaluate the surgical complications of mandibulectomy. This is a retrospective descriptive and analytical study of patients who underwent mandibulectomy in the Department of Maxillofacial Surgery of the CHU JDR Befelatanana between January 2017 and December 2020. A correlation between the occurrence of complications, parameters related to the patients and those related to the surgery was sought. Patient-related parameters were: age and sex, comorbidities, toxic habits and body mass index. The parameters related to the surgery which were studied were the duration of the intervention, the size and the seat of the bone defect, the interruption or not of the mandibular continuity. Forty-six cases were selected. The average age was 36.98 years and the sex ratio was 0.7. Fifty percent of patients developed surgical complications. The total number of complications was 38. Salivary fistula was the most frequent complication (26.32%). No correlation was found between the occurrence of complications and patient-related parameters. There were 69.57% of complications when the procedure lasted more than 180 minutes (p = 0.003). A correlation was found between the occurrence of complications and the size of the resected bone (p = 0.009). Among the complications, 56.52% occurred when the size exceeded 130 mm (p = 0.03). The complication rate is high. The size of the resected bone and the duration of the operation influence the occurrence of complications.