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Feasibility of Parotid Duct Transposition for the Treatment of Dry Eye: A Cadaveric Study

  • Pawan AgarwalEmail author
  • Vinod Dhakad
  • D. Sharma
Original Article
  • 2 Downloads

Abstract

Total dry eye is encountered less frequently, but it may lead to blindness. Transposition of parotid duct to the conjunctival cul-de-sac is a method of treatment for advanced cases of xerophthalmia to prevent blindness. Tears and parotid secretions have similar composition; therefore saliva provides an excellent replacement for tears. Limitation of this procedure is that the length of the parotid duct may not be adequate to reach the conjunctival cul-de-sac. This study was conducted in 30 fresh cadavers to assess the length of parotid duct and technical feasibility of parotid duct transposition for the treatment of dry eye. The parotid duct was dissected and resting length of parotid duct was measured on both sides without stretching. The distance between ear lobule to lateral canthus was also measured on both sides in each cadaver. The length of parotid duct ranges from 4.5 to 7 cm with average length was 5.8 cm. The majority of the cadavers had parotid duct length of 6 cm. Length of the right and left parotid duct was found to be equal in all cadavers. Parotid duct reached comfortably in 24 cadavers (80%) while it was short in 6 cadavers (20%) by 1–1.50 cm in length. Parotid duct can be transposed easily to the lower conjunctival cul-de-sac in majority of the cases. If the parotid duct is falling short than a cuff of the buccal mucosa can be taken in order to gain length.

Keywords

Dry eye Parotid duct Xerophthalmia Tear production 

Notes

Compliance with Ethical Standards

Conflict of interest

All author declares that they have no conflict of interest.

References

  1. 1.
    Jones LT (1966) The lacrimal secretory system and its treatment. Am J Ophthalmol 62:47–60CrossRefGoogle Scholar
  2. 2.
    Shanon E, Lazar M, Redianu C (1973) Surgical treatment of xerophthalmia. Laryngoscope 83:1999–2002CrossRefGoogle Scholar
  3. 3.
    Khurana AK, Khurana AK, Khurana B (2011) Xerophthalmia-systemic ophthalmology-comprehensive ophthalmology, vol 4. Publisher Jaypee Brothers Medical Publishers, New Delhi, p 433Google Scholar
  4. 4.
    Agrawal LP (1953) Tissue therapy in parenchymatous xerosis. Bt J Ophthalmol 37:102–105CrossRefGoogle Scholar
  5. 5.
    Tardy ME, Skolnik EM, Mills JM (1966) Parotid duct transposition in xerophthalmia. Report of a case. Arch Otolaryngol Head Neck Surg 148:778–786Google Scholar
  6. 6.
    Yen HY, Lee C (1954) Transplantation of parotid duct for the treatment of xerophthalmia. Chin J Ophthalmol 6:474–477Google Scholar
  7. 7.
    Bennett JE, Bailey AL (1957) Surgical approach to total xerophthalmia: transplantation of the parotid duct to the inferior cul-de-sac. Arch Ophthalmol 58:367–372CrossRefGoogle Scholar
  8. 8.
    Filatov VP, Chevaljev VE (1951) Surgical treatment of parenchymatous ophthalmoxerosis. J Ophthalmol (Odessa) 3:131–137Google Scholar
  9. 9.
    Ashley FL, Schwartz AN, Straatsma BR, Ford JC (1959) Transplantation of the parotid duct for xerophthalmia. Am Surg 25:815–818PubMedGoogle Scholar
  10. 10.
    Crawford B (1970) Parotid duct transplantation for ocular xerosis. Trans Aust Coll Ophthalmol 2:92–95PubMedGoogle Scholar
  11. 11.
    Rhodes M, Heinrich C, Featherstone H, Braus B, Manning S, Cripps PJ, Renwick P (2012) Parotid duct transposition in dogs: a retrospective review of 92 eyes from 1999 to 2009. Vet Ophthalmol 15:213–222CrossRefGoogle Scholar
  12. 12.
    Kaplunovich PS (1958) Contrast radiography of Stensens duct connection with its transplantation to the conjunctival sac in xerophthalmia and a method of lengthening the duct too short. In: Abstracts of proceedings of the all Russian conference of the ophthalmologists and the twelve extramural session Helmholtz Institute of Eye Diseases, pp 128–129Google Scholar
  13. 13.
    Horsburgh A, Massoud TF (2013) The salivary ducts of Wharton and Stenson: analysis of normal variant sialographic morphometry and a historical review. Ann Anat 195:238–242CrossRefGoogle Scholar
  14. 14.
    Stringer MD, Mirjalili SA, Meredith SJ, Muirhead JC (2012) Redefining the surface anatomy of the parotid duct: an in vivo ultrasound study. Plast Reconstr Surg 130:1032–1037CrossRefGoogle Scholar
  15. 15.
    Mark M, Scott LK, Weinstein G (1995) How I do it; head and neck and plastic surgery; a targeted problem and its solution; “Parotid Duct Transposition for Xerophthalmia and Facial Paralysis”. Laryngoscope 105:80–82CrossRefGoogle Scholar
  16. 16.
    Nicholas JP, Brown FA (1962) Management of epiphora following parotid duct transposition for xerophthalmia. Arch Ophthalmol 68:529–531CrossRefGoogle Scholar
  17. 17.
    Bennett JE, Armstrong JR, Jones RE, Schiller F (1959) Conjunctivoantro-rhinostomy; a gravity drainage operation utilizing the maxillary sinus, with report of two cases. AMA Arch Ophthalmol 62:248–254CrossRefGoogle Scholar
  18. 18.
    Jonws LT (1954) Epiphora: its causes and new surgical procedures for its cure; a preliminary report. Am J Ophthalmol 38:824–831CrossRefGoogle Scholar
  19. 19.
    Geerling G, Sieg P (2008) Surgery for the dry eye. In: Geerling G, Brewitt H (eds): Transplantation of the major salivary glands. Karger, Basel. Dev Ophthalmol 41:255–268Google Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Plastic Surgery Unit, Department of SurgeryNSCB Government Medical CollegeJabalpurIndia
  2. 2.JabalpurIndia

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