Agier Paulina, Kozakiewicz Marcin, Szymor Piotr
Multi-Speciality Dental Clinic, 106/116 Kośćiuszki Av., 90-442 Lodz, Poland.
Department of Maxillofacial Surgery, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland.
J Funct Biomater. 2025 Sep 4;16(9):326. doi: 10.3390/jfb16090326.
Surgical management of condylar process fractures is associated with postoperative complications, the most common being transient facial nerve palsy. Less frequent but noteworthy is the development of salivary fistulas, which, although rare, constitute a clinically relevant condition. This research aimed to investigate factors impacting salivary fistula formation and treatment in patients surgically treated for mandibular condylar process fracture. This study included 395 patients who underwent open rigid internal fixation (ORIF). Salivary fistula occurred in 5.8% of those treated. Multiple factors were assessed as potential contributors to post-operative fistula formation, but only gender demonstrated a statistically significant association as an independent risk factor ( < 0.05). The longer the surgical procedure, the sooner a fistula will appear in the postoperative follow-up period. Moderately elevated white blood cell and C-reactive protein levels were associated with faster resolution of salivary fistula. Treatment duration was longer for patients with a low body mass index. The most effective treatment method was disinfecting the fistula, applying a pressure dressing, and adhering to a tasteless diet ( < 0.05); both chemical cauterization and plastic surgery proved to be less effective. When a fistula occurs, it can be successfully resolved in a relatively short period of time (median 10 days); in most cases, conservative methods are sufficient. As this is a pioneering study, further research is necessary to validate the results.
髁突骨折的手术治疗与术后并发症相关,最常见的是短暂性面神经麻痹。涎瘘的发生虽不常见但值得关注,尽管罕见,但却是一种具有临床相关性的病症。本研究旨在调查影响接受下颌髁突骨折手术治疗患者涎瘘形成及治疗的因素。本研究纳入了395例行切开复位坚强内固定术(ORIF)的患者。接受治疗的患者中有5.8%发生了涎瘘。评估了多个因素作为术后瘘管形成的潜在促成因素,但只有性别作为独立危险因素显示出统计学上的显著关联(<0.05)。手术时间越长,术后随访期间瘘管出现得越早。白细胞和C反应蛋白水平中度升高与涎瘘更快愈合相关。体重指数低的患者治疗时间更长。最有效的治疗方法是对瘘管进行消毒、加压包扎并坚持无味饮食(<0.05);化学烧灼和整形手术均被证明效果较差。当出现瘘管时,可在相对较短的时间内(中位时间10天)成功解决;在大多数情况下,保守方法就足够了。由于这是一项开创性研究,有必要进行进一步研究以验证结果。