Towards a standard of care: Comparing stenting and ligation in parotid duct management for oral cancer.

Abstract

e18124 Background: In oral cancer surgeries requiring resection of the bucco-alveolar complex, ligation of the parotid duct is a standard practice when it lies within the operative field. This approach, however, often leads to parotid salivary fistulas, which can increase drainage fluid, delay wound healing, prolong hospital stays, and defer initiation of adjuvant therapies. We hypothesized that parotid duct stenting, as an alternative to ligation, would reduce these complications by maintaining saliva flow into the oral cavity. Methods: A prospective study was conducted wherein patients undergoing oral cancer surgery were alternately assigned to one of two groups: parotid duct stenting or parotid duct ligation. Stenting was achieved using an infant feeding tube. Data were analyzed using PASW Statistics 18 and included comparisons of mean fluid collection (in milliliters) between the two groups. The primary outcomes measured were incidence of sialocele, volume of drainage, and recovery duration. Statistical analysis was performed using Student's unpaired t-test, with a significance level set at. Results: Group 1 (Stenting; n=9): Mean fluid collection = 12.78±1.39 ml. Group 2 (Ligation; n=16): Mean fluid collection = 25.61±2.89 ml. Statistical significance: The stenting group demonstrated significantly lower fluid collection compared to the ligation group, indicating reduced wound complications and faster recovery. Conclusions: Parotid duct stenting effectively reduces postoperative complications associated with oral cancer surgeries by maintaining salivary flow, thus minimizing the risk of parotid fistulas. This approach has potential to improve patient outcomes, shorten hospital stays, and facilitate earlier initiation of adjuvant therapies. Further studies with larger sample sizes are warranted to validate these findings. Clinical Implications: Parotid duct stenting offers a viable, cost-effective solution to manage saliva drainage in oral cancer surgeries, with significant benefits in reducing postoperative morbidity.