DS28 In search of salivation? Management of parotid duct injury following Mohs micrographic surgery

Abstract Parotid duct injury is a rare complication of cutaneous surgery usually occurring after excision deep infiltrating tumours on the cheek. The existing literature limited to case reports. We present our experience two cases encountered in unit over last 15 years. Our first patient was an 87-year-old man referred for Mohs biopsy-confirmed morphoeic basal cell carcinoma (BCC) his right During tumour extirpation, it necessary sacrifice short section parotid duct. This confirmed by direct visualization and visible salivary leak. Immediate referral made plastic department, who also noted ipsilateral weakness distribution buccal branch facial nerve. repaired lacrimal stent secured mucosa. wound reconstructed with large rhombic transposition flap gland infiltrated botulinum toxin. Four weeks later, had spontaneously fallen out fresh-looking saliva emerging from ampulla. second 65-year-old 3-cm nodular BCC left resected, which clearly layer. On this occasion, colleagues maxillofacial department attended dermatology surgical unit. Under local anaesthesia, cannulated using epidural catheter both intraorally residual absorbable monofilament suture (intraoperative pictures will demonstrate technique). defect bilobed flap. Hyoscine patches were supplied help reduce flow. Marked swelling developed postoperatively, settled without further intervention. After 4 weeks, removed, be flowing Weakness lip elevators keeping nerve injury. Despite infrequency injury, important that surgeons/Mohs surgeons are aware how proceed these cases. In where assistance not available other specialties, technique could undertaken appropriately trained dermatological surgeon/Mohs surgeon anaesthesia.