Year: 2026 | Month: July | Volume: 16 | Issue: 7 | Pages: 191-200
DOI: https://doi.org/10.52403/ijhsr.20260720
Isolated Distal Stenson’s Duct Avulsion Without Facial Nerve Injury Effectively Managed by Intraoral Duct Diversion: A Case Report
Keerthi Krishnanunni1, K Ayyappan2, Anjali S3
1Junior Resident, Department of Oral & Maxillofacial Surgery, Government Medical College, Manjeri.
2Professor & Head, Department of Oral & Maxillofacial Surgery, Government Medical College, Manjeri.
3Senior Resident, Department of Oral & Maxillofacial Surgery, Government Medical College, Manjeri.
Corresponding Author: Keerthi Krishnanunni
ABSTRACT
Stensen’s duct (Parotid duct) injuries are uncommon but clinically significant because of the risk of complications such as sialocele formation, salivary fistula, ductal stenosis, and chronic salivary dysfunction. Early diagnosis and timely intervention are essential to restore physiological salivary drainage and achieve optimal outcomes.
We report the case of a 54-year-old male who sustained a penetrating injury to the right cheek region caused by a bus door piston, resulting in a deep and blind lacerated wound with avulsion of distal end of stensen's duct, without any associated facial nerve injury. The diagnosis was established clinically by directly identifying the avulsed distal ductal end and confirming salivary flow through the ductal orifice upon palpation of the parotid gland.
In such rare cases of duct avulsion injuries, where primary cannulation or microsurgical repair are not ideal, a simple manoeuvre is required to restore both anatomical continuity and functional salivary flow. Management involved intraoral diversion of the proximal segment and its anastomosis to the adjacent oral mucosa, closer to its pre-existing position opposite to the maxillary second molar, thereby reestablishing a functional intraoral ductal opening and restoring physiological salivary drainage. Intraoral duct diversion provides a technically straightforward, chairside approach that can be performed during the initial management of the injury itself, thereby reducing the likelihood of subsequent complications requiring secondary intervention.
This patient was reviewed at subsequent intervals for up to three months to assess ductal patency and wound healing. The procedure successfully restored the structural anatomy and functional salivary drainage, with established ductal patency and satisfactory gland function throughout the follow-up period, demonstrating the effectiveness of this technique.
This case highlights intraoral duct diversion as a simple, reliable, and effective surgical option for the management of stensen’s duct avulsion injuries, underscoring the novelty of this technique.
Key words: Salivary duct trauma, Duct avulsion, Stensen’s duct diversion, Duct patency, Sialocele, Penetrating parotid injury, Case report