Unusual Spontaneous Salivary Fistula: a Retrospective Review of the Last 12 Years

Aims: To analyse retrospectively all cases of spontaneous salivary fistulae studied by radiological imaging from January 1999 to December 2011. Salivary fistulae are uncommon; they could be congenital or acquired caused by injury, neoplasm, surgery or may represent a rare long-term complication of sialolithiasis and/or recurrent sialoadenitis. Materials and methods: We retrospectively report our 12 years experience in patients with proved unusual intraoral spontaneous salivary fistula. All ours patients were referred for classical symptoms as recurrent salivary infection and purulent oral discharge. Results: 6 cases of intraoral inflammatory salivary fistulae were studied (5 submandibular, 1 parotid), 3 cases were related to sialoliths and other 3 to sialoadenitis; among them 2 have both sialoliths and active adenitis. All patients underwent to sialography and fistulography and all fistulous tracts were detected. Different diagnostic options were applied according to the localization of fistulae. Conclusion: Looking to our experience we suggest studying patients with sialography and/or fistulography and Magnetic Resonance (MR) especially for patients with a high probability of being subjected to major surgery. MR allows to see fistulae, relation between fistulae and near tissue, and to distinguish inflammation from other pathology. Computed Tomography (CT) is ideal to study shape and dimension of sialolith and to evaluate eventual bone involvement.