Parotid Duct Transposition
Why Should I Bring my Pet to Willows for Parotid Duct Transposition Surgery?
Willows is one of Europe’s leading small animal referral centres. Our state-of-the-art hospital is led by internationally renowned Specialists, committed to providing the highest standards of veterinary care. Our Ophthalmologists are supported by our multi-disciplinary team of Specialists across a number of disciplines including; Anaesthesia, Diagnostic Imaging and Emergency and Critical Care.
Willows also has a large dedicated team of Nurses and clinical support staff available 24 hours a day, every day of the year to provide the best possible care for your pet.
Parotid Duct Transposition in the Treatment of Dry Eye
A small proportion of dogs suffering from dry eye do not respond to medical management. In these patients the problem is unfortunately so severe that the eye remains painful and badly diseased despite the use of immunosuppressive agents and artificial tears. In order to alleviate discomfort and prevent vision-threatening corneal scarring (or even ulceration and rupture of the eyeball), the procedure known as a Parotid Duct Transposition is often carried out in such severe cases.
What is a Parotid Duct Transposition?
The parotid duct is a tube that carries saliva from the parotid salivary gland into the mouth. In a Parotid Duct Transposition, this duct is surgically relocated from the mouth into the pocket below the eye, which results in the eye being kept moist with saliva instead of the tears.
Saliva does not have exactly the same composition as tears. However, it is usually well tolerated and can prevent the severe effects of chronic dry eye in the majority of dogs. A minority of patients show signs of irritation from the saliva. In some cases, surgery will not resolve the signs of discomfort and in these circumstances the operation may have to be reversed.
Fig1: The opening of the parotid duct (arrowed) has been stitched into the pocket below the eye using very fine sutures
What Can I Expect if my Dog is Treated with Parotid Duct Transposition Surgery?
The surgery is carried out under general anaesthetic and the side of the face is clipped. Magnifying glasses are worn by the Surgeon to allow visualisation of the parotid duct and to prevent damage to the delicate tissues surrounding the duct. An incision is made into the skin on the side of the face, after identifying and mobilising the duct its opening (the papilla) is freed from the normal position in the mouth, and moved into the pocket below the eye where it is stitched into place with self-dissolving sutures. The incision on the side of the face is then closed using small sutures.
Following surgery, the patient needs to wear a collar to prevent damage to the wound by rubbing or scratching. An antibiotic ointment is generally applied to the eye for ten days after surgery. The facial wound should not require any attention, and suture removal (if required) is carried out after ten to twelve days. A short course of antibiotics and mild painkillers are usually dispensed. The patient is fed little and often to stimulate saliva production and it is necessary to check that saliva flows into the eye at the time of each feeding.
In some patients, the side effect of excessive saliva may occur at feeding time or during excitement (e.g. on exercise, car journeys etc.). In this case, saliva may flow over the eyelids onto the side of the face. If salivary overflow is marked, staining of the facial hair and inflammation of the skin can occur. In some patients, calcium salt crystals from the saliva are deposited on the corneal surface and the eyelid edges. Rarely, corneal ulceration can occur in association with the mineral deposits and surgery of the affected area may be necessary. Ocular lubricants and occasionally a change in diet may be used to try to reduce calcium salt deposition.
Will I still need to apply eye drops after the parotid duct transposition?
Generally, medication will be stopped, following a short course of antibiotic eye ointment immediately after surgery. Some patients will benefit from the occasional use of a lubricant eye ointment. A parotid duct transposition allows the owners of affected patients to resume a relatively normal life-style without the constant application of eye treatments.
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Ophthalmology
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To assist owners in understanding more about Ophthalmology we have put together a range of information sheets to talk you through the some of the more common conditions seen and treated by our Specialists.
