Parotid Fistula: A Rare Complication of Extensive Odontogenic Keratocyst
- 12.11.2025
- CASE REPORT
- Verfasst von
- Monika Parmar
- Vishakha Sharma
- Saransh Guleria
- Likshandeep Singh
- Saniya Masood
- Erschienen in
- Journal of Maxillofacial and Oral Surgery
Abstract
Background
The odontogenic keratocyst (OKC) is a benign but locally aggressive cystic lesion known for its erosive potential and high recurrence (5–62%) rate. While parotid involvement is exceptionally rare, the OKC’s bone erosive ability can lead to the formation of a fistula draining extra-orally through the parotid region.
Case Presentation
A 43-year-old female presented with a 2-week history of painful swelling with draining sinus in the left pre-auricular region. Initial clinical examination and imaging revealed a fistula tract originating from a large, infected cystic lesion in the mandibular ramus that had eroded through the buccal cortex into the parotid gland. The patient was treated with a two-part approach: surgical enucleation of the cystic lesion turning out to be OKC and serial injections of hypertonic saline (3% NaCl) into the fistula tract to induce fibrosis and promote closure.
Conclusion
This case highlights the importance of considering an odontogenic keratocyst in the differential diagnosis of parotid fistulas, particularly when a bony lesion in the posterior mandible or condyle is present. It also demonstrates hypertonic saline as a cost-effective and minimally invasive adjunct therapy that can effectively manage and close persistent fistulas, thereby reducing the need for more complex and invasive surgical interventions.
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- Titel
- Parotid Fistula: A Rare Complication of Extensive Odontogenic Keratocyst
- Verfasst von
-
Monika Parmar
Vishakha Sharma
Saransh Guleria
Likshandeep Singh
Saniya Masood
- Publikationsdatum
- 12.11.2025
- Verlag
- Springer India
- Erschienen in
-
Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Elektronische ISSN: 0974-942X - DOI
- https://doi.org/10.1007/s12663-025-02782-z
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