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SALIVARY FISTULiE AND CONCRETIONS. 
cut surface of such concretions often presents a stratified appearance, and 
a central nucleus of awns, straw, &c. 
Symptoms. The concretion is only remarked after it has attained a 
certain size. It appears as a hard, sharply defined, slightly movable 
swelling, generally lying on the outer surface of the under jaw, close in 
front of the buccal opening of Stenson’s duct, but sometimes on the 
posterior border of the under jaw. The salivary duct is usually distended 
behind the swelling, and when the flow of saliva is entirely shut off the 
gland is enlarged. Inflammation is seldom present, but may appear and 
lead to formation of abscesses. 
Treatment consists in operative removal. Small concretions may 
perhaps be forced through the duct, which will necessarily be somewhat 
fissured ; the larger require an incision to be made in the duct. In this 
case a transverse cut is preferable to a longitudinal one, on account of 
its healing more easily, and not so frequently leading to salivary fistula. 
Recovery is hastened by observing strict antiseptic precautions before 
and during operation, carefully suturing the wound, and withdrawing 
food for one to two days. Bayer removed a concretion from the duct 
through a longitudinal incision, and after closing the wound with 
Lembert’s suture, effected healing by first intention. In some cases, 
where the calculus is lodged very near the opening of the duct, it may 
be removed by incision from the buccal cavity. Such cases are rare, but 
the fact is woith lemembering, as this method avoids the occurrence of 
a salivary fistula. 
(5) SALIVARY FISTULA. 
Wounds of the salivary glands and their ducts often fail to heal, 
because the continual flow of saliva pushes aside the granulations and 
hinders closure. The gland epithelium finally unites with that of the 
outer skin, and through the opening so formed saliva flows continuously 
(salivary fistula). A distinction must be made between fistula of the 
salivary gland and of the salivary duct. The latter occur most frequently 
in Stenson’s duct. Although the general condition of the animal is only 
slightly affected, much saliva escapes during eating and mats the hair of 
the cheek, finally producing a blemish. Fistulas of salivary glands heal 
more easily than those of salivary ducts,—sometimes, indeed, without 
treatment of any kind. 
Treatment aims at closing the external opening. This may he done by 
cauterising with nitric acid, silver nitrate, concentrated carbolic acid, or 
the actual cautery. A scab is thus formed, which checks the outflow of 
saliva, allows the formation of granulations, and promotes cicatrisation. 
These methods sometimes fail at first, and require to be repeated. The 
draw-purse suture may prove useful. 
