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Pneumoparotid

Case contributed by Charlie Chia-Tsong Hsu
Diagnosis certain

Presentation

Right facial pain.

Patient Data

Age: 60 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

ct

Non-contrast CT head demonstrates air within the right Stensen's duct and the acini of the parotid gland. Both parotid glands appear symmetric and there is no periglandular stranding/inflammation.

The normal path of the Stensen's duct is exquisitely outlined by air as it courses over the masseter muscle before piercing the buccinator muscle. 

Case Discussion

Pneumoparotid may be due to raised intra-oral pressure resulting in incompetence of the valvular mechanism created by the angulated distal intramuscular segment of the Stensen's duct and the buccinator muscle. This may be occupational-related from playing wind instruments, SCUBA diving or iatrogenic. Recognizing this entity is important as the patient may be prone to superimposed parotitis/infection due to the loss of normal valvular mechanism. 

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