Management of chronic duct dilatation

Parotid strictures can present with a long history of postprandial pain and swelling. In a small number of cases this leads to gross dilatation of the parotid duct along its length, presumably due to a chronic raised intraductal pressure. The management of this condition is unclear. Nine patients were treated between 2004 and 2009. The median history of symptoms was 8 years ranging from 4-30 years. Sialendoscopy assisted ductoplasty was carried out in 7 cases. The median follow-up period was 12 months (range 2-24 months). 5/9 patients were symptom free at 1 year review. In one patient, the stricture reformed and stones formed in the dilated duct, another had complete obstruction and another required ligation of the duct. Gross dilatation of the parotid duct is a rare occurrence, with few clinicians having any experience of management. An attempt in 8 consecutive cases was made to relieve obstruction by ductoplasty. This was only partially successful. The tendency is for the stricture to reform at the ostium.