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The waiting game

Salivary fistula after parotid surgery

Dr Andy Jordan's photographs of an unusual presentation in his surgery

This 40-year-old developed a lump in his left parotid gland about a year previously, writes Dr Andy Jordan. Fine needle aspiration had not contributed to the diagnosis and an MRI scan revealed a 3cm diameter solid lesion in the superficial gland.

A superficial parotidectomy had been performed (near right) and this had been complicated by the development of a haematoma, which was aspirated by the ENT consultant.

Four weeks after the operation he came to see me complaining that at mealtimes he suffered leakage of fluid from a small section of the wound (centre right). There was no sign of infection and the fluid was sterile. He had developed a salivary fistula which, according to the ENT surgeons, was not uncommon.

It healed over the following four weeks without any further intervention (far right).

The tumour was a benign basal cell adenoma.

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