Canis ISSN: 2398-2942

Parotid duct transposition (PDT)

Contributor(s): Rhea Morgan

Introduction

  • Surgical technique to move the papilla and parotid duct from the mouth to the inferior conjunctival cul de sac of the eye for the purpose of providing lubrication to the eye in cases of refractory keratoconjunctivitis sicca (KCS) Keratoconjunctivitis sicca.

Uses

  • Cases of KCS unresponsive to cyclosporine Ciclosporin therapy.
  • Animals with KCS that are not comfortable on medical therapy alone.

Advantages

  • Provides a copious amount of watery saliva to lubricate the eye.
  • May prevent blindness in some animals.
  • Improves the comfort level of those animals that have persistent blepharospasm Blepharitis on medical therapy.

Disadvantages

  • Saliva is not the same composition as aqueous tears, so lubrication of the eye is sometimes complicated by mineral deposition on the cornea and eyelids.
  • The animal must be stimulated to salivate frequently.
  • The quantity of saliva produced with each stimulus cannot be controlled and may be excessive.

Technical problems:

  • Cannulation of the papilla can be difficult.
  • Dissection of the duct is tedious.
  • Suturing of the papilla into the cul de sac must be done carefully.
  • Kinking or twisting of the duct may prevent adequate function.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • With careful surgical technique, the prognosis for successful outcome of the surgery is good.
  • Most eyes tolerate the saliva well, with a decrease in pigmentation and vascularization of the cornea over time. Clearing of the cornea may be enhanced by the use of topical antibiotic/steroid preparations for a while, once the sutures have dissolved from the inferior cul de sac.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Termote S (2003) Parotid salivary duct mucocoele and sialolithiasis following parotid duct transpositionJ Small Anim Pract 44 (1), 21-23 PubMed.
  • Stanley R G (1997) Failure of parotid duct transposition due to sialolith formation. Vet Compar Ophthalmol (2), 126-127 VetMedResource.

Other sources of information

  • Bistner SI, Aguirre G, Batik G (1977)Atlas of Veterinary Ophthalmic Surgery. WB Saunders, Philadelphia, pp 132-137.
  • Slatter D (2001)Fundamentals of Veterinary Ophthalmology. 3rd Ed. WB Saunders, Philadelphia, pp 255-257.


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