PMC3952286_01
Small cutaneous opening in the post-auricular region (blue arrow) near mastoid tip discharging clear fluid (saliva)
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F1
On examination, there was a small cutaneous opening near mastoid tip behind the ear lobule, which discharged clear fluid (saliva) on pressing the parotid gland [Figure 1].
(a and b) Computed tomography ialography after cannulation of right Stensen's duct and injection of radio-opaque contrast (red arrow) showing a fistulous tract connecting the sub segmental duct of parotid gland (blue arrow) extending along pre-tragus region in subcutaneous plane (green arrow) up to mastoid tip (yellow arrow) after passing inferior to external auditory canal
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F2
Superficial parotidectomy via an S-shaped incision with excision of the tract. The tract (yellow and blue arrows) ending into the parotid gland is seen superficial to the branches of the facial nerve (green arrows)
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F3
The tract was superficial to the branches of the facial nerve and ended into the parotid gland [Figure 3].
Histopathology (H and E, x4) showing sinus tract (red arrow) and acini of parotid gland (green arrow)
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F4
Histopathology revealed sinus tract comprising of ectodermal components and acini of the parotid gland [Figure 4].