84 
SALIVARY FISTULA. 
into the mouth. Where stricture of the duct occurs, as it often does, 
at a point between the fistula and the natural opening, this must be 
remedied. Lindenberg recommends passing a strong probe, and then 
attempting to reclose the walls of the fistula by caustic or the cautery. 
The resulting inflammatory swelling may close the wound, but healing 
will be more assured if a stitch be inserted. The purse-string stitch is 
the best. \\ ith a strongly curved needle a thread is passed through the 
Fig. 52.—Parotid gland and Stenson’s duct. (Semi-schematic.) 
A, Tendon of the stylo-maxillaris ; B, parotid gland ; C, Stenson’s duct. The lines D and E 
should he prolonged. They are intended to point to the facial vein and artery—the latter 
indicated by the strong cross-shading, the vein being next it towards the left. 
skin around the opening of the fistula, and the margins thus brought 
together. Where the natural opening into the mouth cannot he renewed, 
an artificial conduit must be provided. Stockfleth recommends exposing 
the duct behind the fistula, and piercing the cheek in an oblique direc¬ 
tion with a trochar. The free portion of the salivary duct is introduced 
into this opening, and made fast with a suture. Lafosse and Hering 
pass a thread through the cheek by means of a trochar, and fasten the 
ends together in the corner of the mouth. After the thread has remained 
in position for some weeks it is removed, and the opening closed with a 
suture. In man a thin drainage-tube or piece of lead-wire has been 
used in a similar way. Labat, in a horse, kept the artificial opening 
