Obstructed parotid duct: MR sialogram

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Long standing left facial pain, worse with eating meals

Patient Data

Age: 35
Gender: Male

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)

ultrasound

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

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