Salivary fistula is a relatively common complication in patients treated with parotidectomy. Salivary fistulas could persist for a long period after complete wound healing, which may lead to visible scarring and wound infection. To meet this challenge, we aimed to investigate the effect of bipolar coagulation forceps in salivary fistulas. In this study, the results suggested that the parotidectomy patients treated with bipolar coagulation forceps had a lower incidence of salivary fistulas.
The disease management always consist of diagnosis and therapy. The recent study suggested that drain fluid amylase could serve as a predictor for postoperative salivary fistula in benign parotid tumors. The parotid capsule’s persistence was correlated with salivary fistula, while closure of the parotid capsule had no effect on deceasing of salivary fistula postoperatively. The results indicated that the size of parotidectomy wound area determined occurrence of salivary fistula postoperatively. For decreasing salivary fistula incidence, the previous studies reported many therapeutic techniques including reduction in oral intake and parenteral feeding, sewn site of the salivary leak, application of restranining bandage, use of anticholinergic agents[8, 9], injection of botulinum toxin[10–12], application of cyanoacrylates after closing skin incision, the resection of tympanic nerve, and management of radiation therapy. In present study, our results showed that the application of bipolar coagulation forceps decreased the incidence of salivary fistula in parotidectomy patients. It could serve as a novel treatment for salivary fistula. As we expected, the patients in control group had more draining output than experimental group.
Electrosurgical instruments, producing heating, was used to control bleeding in surgical procedures. Bipolar coagulation forceps always applied as hemostatic devices in operation[17, 18]. In present study, we found that the patients treated with bipolar coagulation forceps had a lower incidence of salivary fistula. Due to fragile characteristic of parotid gland, the parotid wound region, treated with surgical suture, easily developed to wound dehiscence postoperatively, caused salivary fistula. However, the bipolar coagulation forceps could seal parotid wound region between the forceps, which facilitated the fresh gland wound healing. This may explain that the parotid wound treated surgical suture had a high incidence of salivary fistula. The study of Zou showed that methylene was injected into Stensen’s duct for ligating the broken duct, while the broken intercalated duct and secretory duct hardly had been ligated. The application of bipolar coagulation forceps could resolve the problem. The convenience is the most advantage of bipolar coagulation forceps with universal application for hemostasis.