Parotid duct injury secondary to shark bite injury
Published online on 11. October 2016
Parotid duct injury secondary to shark bite injury: Repair with a Crawford stent
Mallory Highstein, Tristan Tham, Prabhjyot Singh, Peter Costantino
ABSTRACT:
Introduction
Here we present a unique case of repair of a parotid injury caused by a shark attack. The repair technique is of interest due to the novel use of a Crawford stent, typically reserved for lacrimal duct injuries.
Case description
Our patient is a 43-year-old man who suffered a shark bite injury to the face and head ten days prior to surgery. The patient presented with multiple lacerations and a sialocele. During the surgery, a sialendoscope and open incision were used to find the duct laceration. The surgeon decided to utilize a Crawford stent as the stiff metal probe would satisfactorily delineate the structure and anatomy of Stenson’s duct.
Discussion
Often, diagnosis of parotid gland trauma is missed at the time of injury, leading to later complications. In this procedure, we used a Crawford stent as its intrinsic stiffness allows it to tunnel through the duct easily.
Conclusion
Clinicians should have a high level of suspicion for parotid duct injury in a patient presenting with injury to the face, particularly with laceration type injuries. Our patient had a unique injury that required a novel Crawford stent repair over traditional silicone catheters.
JPRAS Open, Volume 10, December 2016, Pages 28–32, doi: 10.1016/j.jpra.2016.09.001