SALIVARY FISTULA 119 



fistulse appearing from time to time may extend over several 

 months. In fistula of the duct, the saliva flows freely and 

 increases where food is offered or taken. 



Diagnosis. The chronicity and the character of the dis- 

 charge are usually sufficient to make a diagnosis. 



Prognosis. Unfavorable. 



Treatment. When the fistula is distant from the gland, 

 probe carefully until the origin is reached. Open the skin 

 at this point and apply treatment direct to the opening in 

 the duct or gland. Tincture of iodin applied direct to the 

 opening leads to swelling which occludes the opening. 



In obstinate cases the thermocautery should be used. 

 When Steno's duct is open, suturing may be attempted. 

 When all treatment fails complete destruction of the gland 

 by repeated injections of iodin directly into the gland or 

 extirpation should be practised. 



