Presentation
Right facial swelling and fevers.
Patient Data
A 7 x 3 mm calcific density calculus is present within the distal right parotid duct. The duct proximal to the calculus is significantly dilated (up to 4 mm diameter) and demonstrates thickened, enhancing walls. The right parotid gland is atrophic relative to the left side and is hyperenhancing. Inflammatory stranding surrounds the gland. No parotid collection.
Case Discussion
Typical appearance of parotid duct sialolithiasis. Atrophy of the parotid duct in this case indicates chronic obstruction.
Sialadenitis can relate to obstruction (inflammatory), or infection. An obstructing stone predisposes to infection by oral commensals.