PMC4336664_01
Pinpoint opening over scar tissue.
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F1
A small pinpoint opening (Figure 1) was seen just above the scar from which watery fluid discharged spontaneously which increased on sucking lemon.
Salivary flow intra-orally.
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F2
Mild salivary flow was seen from right parotid papilla along with more flow from fistula on milking of right parotid gland and rest of the oral cavity showing normal wet ability with saliva (Figure 2).
Gutta-percha in fistula.
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F3
On radiographic examination with insertion of gutta percha point in the fistula revealed in the parotid region (Figure 3).
Fistulography.
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F4
Hence, a false filling defect in radiograph was noted, and solution could not enter the gland because of direct communication of fistulous tract and duct (Figure 4).
Relation of fistulous tract with Stenson's duc
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F5
Superficial lobe of the parotid was carefully dissected, and fistulectomy was done after ligating the attachment of the fistulous tract to the Stenson's duct (Figure 5).
Suturing.
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F6
Closure was done in two layers using vicryl 3-0 and nylon 4-0 sutures (Figure 6) followed by tight pressure dressing.
Follow-up after 1 year.
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F7
Regular follow-up was done for 1 year, the fistulous tract healed satisfactory (Figure 7) and no complain of recurrence was encountered by the patient.