Before harvesting the anterolateral thigh (ALT) flap pedicle, we harvested one of the two venae comitantes of sufficient length and anastomosed it to the duct (Fig. 1B, C). The distal end of the reconstructed parotid duct was fixed between the flap and the oral mucosa (Fig. 1D). We inserted a silicone tube to prevent a stricture forming in the suture site of the parotid duct and the neo-duct created using the vena comitans.

When a parotid duct is injured, surgical treatment is recommended to avoid salivary fistulas or sialoceles, and a silicone tube is generally inserted during surgical reconstruction to prevent stricture of the anastomosed duct [1-3]. In previous studies, the mean diameters of the distal portion of the parotid duct, the venae comitantes of ALT flap pedicle were about 1.4 mm and 2.5 mm, respectively [4,5].

We have reported satisfactory reconstruction outcomes by performing primary parotid duct reconstruction using venae comitantes of the flap pedicle. The study was approved by the Institutional Review Board of Yeungnam University Medical Center (IRB No. YUMC 2018-07-047-001) and performed in accordance with the principles of the Declaration of Helsinki.