Clinical Image

Suppurative Parotitis with Multiple Sialoliths

Sadaksharam Jayachandran and Bhaumik Joshi*
Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College & Hospital, Chennai 600 003, Tamil Nadu, India


*Corresponding author: Bhaumik Joshi, Department of Oral Medicine and Radiology, Tamilnadu Government Dental College and Hospital, Affiliated with Tamilnadu Dr MGR Medical University, Chennai-03, Tamilnadu, India


Published: 22 Sep, 2017
Cite this article as: Jayachandran S, Joshi B. Suppurative Parotitis with Multiple Sialoliths. J Dent Oral Biol. 2017; 2(16): 1097.

Clinical Image

A 40-year-old female presented with pain and swelling over left side of face for past 6 months. On examination a firm swelling was present over left parotid region (Figure 1A). Intraorally, inflamed Stenson’s duct papilla revealed pus discharge on milking of the Parotid gland (Figure 1B). On Plain radiography, a radiopaque mass was present on Left parotid region. Presence of four distinct hyperdense structures throughout the tract of Stenson’s duct suggestive of Sialoliths was noted on Cone-Beam CT (Figure 1C). MRI showed diffuse T2 hyperintensity throughout the enlarged gland, sausage pattern appearance of Left Stenson’s duct (Sialodochitis) and intraductal and intra-glandular Sialoliths (Figure 1D). A Diagnosis of Acute Suppurative Parotitis secondary to Sialolithiasis was made and Sialoliths were removed surgically. Patient is under follow up. Sialolithiasis in Parotid is relatively rare condition with incidence of 6% to 15% amongst all Sialolithiasis [1]. Modalities for stone removal include use of Dormia basket with Sialendoscopy, extra-corporeal shock-wave lithotripsy and Parotidectomy in patients with multiple stones [2].


Figure 1

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Figure 1
Parotitis with Multiple Sialoliths.

References

  1. Graziani F, Vano M, Cei S, Mario G. Unusual asymptomatic giant sialolith of the submandibular gland: A clinical report. J Craniofac Surg. 2006;17(3):549-52.
  2. Konstantinidis I, Paschaloudi S, Triaridis S, Fyrmpas G, Sectilidis S. Bilateral multiple sialolithiasis of the parotid gland in a patient with Sjögren's syndrome. Acta Otorhinolaryngol Ital. 2007;27(1):41-4.