Presentation
Long standing left facial pain, worse with eating meals
Patient Data
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Dilated left parotid duct from the gland extending up to the left cheek where there is a tapered narrowing. Note the asymmetry when compared with the right (arrows). Note also the dilated accessory duct entering the main duct (best seen on the sagittal imaging)
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US confirms the MRI findings and shows minor increase in vascularity in the gland parenchyma. No intra-luminal calculus at the distal end of the duct in the cheek.
Case Discussion
Catheter sialography is fiddly and uncomfortable for the patient. MR sialography is a useful alternative especially if the ducts are dilated