Parotid gland sialolithiasis

Findings

Parotid duct stone, dilated duct, and associated L parotid enlargement with some mild inflammatory changes.


Diagnosis: Parotid gland sialolithiasis


Key points

Sialolithiasis

80-92% sublingual; 6-20 % parotid; 1-2% minor salivary glands.
1% incidence in autopsy studies; much less commonly symptomatic.
Males > Females; Usually 30-60 y/o.
75% single stones; 5% bilateral.
Sxs: Swelling, discomfort surrounding affected gland. May wax and wane.


Sialadenitis

Enlarged, inflamed gland; May have systemic symptoms.
More elderly, dehydrated, debilitated patients.
May be secondary to obstructing stone, bacterial (MC S. aureus), viral, post XRT.

Important complications:
- Secondarily infected as a result of ductal obstruction/stasis (especially in elderly patients).
- Erosion of calculus through duct wall with chronic fibrotic reaction.
- Poorly functioning gland secondary to chronic inflammation.