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Ultrasound-guided botulinum toxin injection to treat a parotid fistula following gunshot injury
  1. Gulcan Gok1,
  2. P Michl2,
  3. M D Williams1 and
  4. D C Howlett3
  1. 1Department of Oral and Maxillofacial Surgery, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
  2. 2Department of Oral and Maxillofacial Surgery, Palacky University Olomouc, Olomouch, Czech Republic
  3. 3Department of Radiology, Eastbourne District General Hospital, Eastbourne, East Sussex, UK
  1. Correspondence to Dr Gulcan Gok, Speciality Doctor in the Oral and Maxillofacial Surgery Department, The Eastbourne District General Hospital, Kings Drive, Eastsussex, Eastbourne BN21 2UD; gulcangok43{at}


Parotid fistula is a rare but very distressing sequelum of post-operative or traumatic injuries. The management of these injuries has been reported in the literature previously and techniques employed include pressure dressings, surgery and more recently botulinum toxin A (BTA) injections. We present a patient who developed a parotid fistula as a late complication of an extensive gunshot injury to the face with subsequent successful management with ultrasound-guided intraglandular injections of BTA. This case demonstrates that the BTA injection is an effective and safe method under ultrasound guidance and should considered as a first-line treatment option for the treatment of salivary fistulas.

  • ORAL & Maxillofacial Surgery
  • Radiology & Imaging

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