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Martinez I, Mielke B, Rutherford L, Cantatore M, Cinti F, Charlesworth T, de la Puerta B, Rossanese M. Clinical findings, surgical treatment and outcome in dogs with parotid duct ectasia: 14 cases (2010-2023). J Small Anim Pract 2024; 65:198-205. [PMID: 37936527 DOI: 10.1111/jsap.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 09/20/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES To describe the clinical presentation, diagnostic findings, surgical treatment and outcome of dogs diagnosed with parotid duct ectasia. MATERIALS AND METHODS Medical records of dogs diagnosed with parotid duct ectasia between 2010 and 2023 at six small animal referral hospitals were retrospectively reviewed. Outcome was assessed by contacting the owners or referring veterinarians. RESULTS Fourteen dogs were included. Lateral facial swelling was the most common clinical presentation. CT revealed a tortuous cavitary tubular fluid-filled structure consistent with a dilated parotid duct in all dogs. Surgical treatment included marsupialisation of the parotid duct papilla, surgical exploration of the duct alone, parotid duct marsupialisation with surgical exploration of the duct, parotidectomy or en-bloc parotid duct resection. The aetiology of parotid duct ectasia was not established in 13 of 14 dogs. In one case, a foreign body was retrieved from the duct. No recurrence of clinical signs was noted during the follow-up period (range 21 to 2900 days). CLINICAL SIGNIFICANCE Parotid duct ectasia should be considered for dogs with a lateralised fluctuant non-painful tubular facial swelling. Surgical management was associated with a favourable prognosis without evidence of recurrence in all cases reported in the case series.
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Affiliation(s)
| | - B Mielke
- Southpaws Speciality Surgery for Animals, Melbourne, Victoria, Australia
| | - L Rutherford
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
| | - M Cantatore
- Anderson Moores Veterinary Specialists, Winchester, UK
| | - F Cinti
- Surgery Department, San Marco Veterinary Clinic and Laboratory, Veggiano, Italy
| | - T Charlesworth
- Eastcott Referrals, Edison Business Park, Dorcan Way, Swindon, UK
| | - B de la Puerta
- North Down Specialist Referrals, Bletchingley, United Kingdom
| | - M Rossanese
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
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Tirillini F, Baines SJ, Baines E, Robinson W. Computed tomographic findings in two dogs with chronic unilateral parotid duct ectasia. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
A 3yr old spayed female Brittany was referred with a cylindrical mass on the right side of her face. Three months earlier, a small stone embedded in the right parotid duct was noted and removed through a ductal incision by the referring veterinarian. At referral, the dog's general physical condition was normal except for a cylindrical mass on the right cheek. Skull radiographs showed a possibly retained sialolith or dystrophic mineralization within the previous surgical site. Aspiration of the mass yielded a thick, yellow/tan, mucopurulent fluid. Cytology of the fluid demonstrated degenerative neutrophils without bacteria. The cylindrical mass was excised with a carbon dioxide laser. The caudal end of the mass was connected to the parotid salivary gland and the rostral one-third of the mass tapered to a point. The caudal end of the mass was ligated with 3-0 polydioxanone and excised immediately rostral to the ligation. Histopathology revealed that the mass was parotid duct ectasia. The dog completely recovered with some mild temporary facial paresis and had no recurrence of parotid duct ectasia at 4 mo follow-up. The case report describes a dog with an unusual parotid salivary duct ectasia caused by parotid duct sialolith removal.
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Affiliation(s)
- Hyun-Jung Han
- From the Department of Veterinary Surgery, College of Veterinary Medicine (H-Y.Y.), and Department of Veterinary Emergency Medicine, Konkuk Veterinary Medical Teaching Hospital (H-J.H.), Konkuk University, Seoul, South Korea; and Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M.)
| | - F A Mann
- From the Department of Veterinary Surgery, College of Veterinary Medicine (H-Y.Y.), and Department of Veterinary Emergency Medicine, Konkuk Veterinary Medical Teaching Hospital (H-J.H.), Konkuk University, Seoul, South Korea; and Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M.)
| | - Hun-Young Yoon
- From the Department of Veterinary Surgery, College of Veterinary Medicine (H-Y.Y.), and Department of Veterinary Emergency Medicine, Konkuk Veterinary Medical Teaching Hospital (H-J.H.), Konkuk University, Seoul, South Korea; and Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri (F.A.M.)
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4
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Le Roux MK, Graillon N, Hadj-Saïd M, Scemama U, Lutz JC, Chossegros C. Stensen duct dilation: Case series of minimally invasive treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:e114-e117. [PMID: 30878397 DOI: 10.1016/j.oooo.2019.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
Abstract
Stensen's duct dilation is a rare condition characterized by a global or partial idiopathic dilation of the Stensen duct. Affected individuals usually show either aesthetically compromised features, such as a tubular-shaped swelling in the cheek, or with mildly painful inflammatory episodes. Three women between ages 61 and 67 years were diagnosed with Stensen duct dilation after sialo-magnetic resonance imaging (MRI). They were treated with botulinum toxin A (BTX-A). Our preliminary results suggest that BTX-A was efficient as a suspensive treatment. BTX-A should remain a first-line treatment of the early silent symptoms of Stensen duct dilation, such as swelling and aesthetic issues. The use of BTX-A avoids more serious procedures and further complications.
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Affiliation(s)
- Marc-Kevin Le Roux
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France.
| | - Nicolas Graillon
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Mehdi Hadj-Saïd
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Ugo Scemama
- Aix Marseille University, SPMC EA 3279, Marseille, France; Department of Radiology, Hôpital Nord, Aix-Marseille University, chemin des Bourrely, Marseille, France
| | - Jean-Christophe Lutz
- Stomatology and Maxillo-Facial Surgery Department, Strasbourg University Hospital, Strasbourg cedex, France
| | - Cyrille Chossegros
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
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5
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Koch M, Iro H. Salivary duct stenosis: diagnosis and treatment. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:132-141. [PMID: 28516976 PMCID: PMC5463521 DOI: 10.14639/0392-100x-1603] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022]
Abstract
The management of stenoses of the major salivary glands had undergone a significant change during the last 15-20 years. Accurate diagnosis forms the basis of adapted minimal invasive therapy. Conventional sialography and MR-sialography are useful examination tools, and ultrasound seems to be a first-line investigational tool if salivary duct stenosis is suspected as cause of gland obstruction. Sialendoscopy is the best choice to establish final diagnosis and characterise the stenosis in order to plan accurate treatment. In all major salivary glands, inflammatory stenosis can be distinguished from fibrotic stenosis. In the parotid duct system, an additional stenosis associated with various abnormalities of the duct system has been reported. Conservative therapy is not sufficient in the majority of cases. The development of a minimally invasive treatment regime, in which sialendoscopy plays a major role, has made the preservation of the gland and its function possible in over 90% of cases. Ductal incision procedures are the most important measure in submandibular duct stenoses, but sialendoscopy becomes more important in the more centrally located stenoses. Sialendoscopic controlled opening and dilation is the dominating method in parotid duct stenoses. In 10-15% of cases, success can be achieved after a combined treatment regime had been applied. This review article aims to give an overview on the epidemiology, diagnostics and current state of the art of the treatment of salivary duct stenoses.
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Affiliation(s)
- M Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
| | - H Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen, Nuremberg, Germany
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Vatin L, Foletti JM, Collet C, Varoquaux A, Chossegros C. A case of bilateral megaducts: Diagnostic and treatment methods. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:125-128. [PMID: 28345516 DOI: 10.1016/j.jormas.2017.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/20/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The pathology of the saliva glands comprises both tumoral and obstructive disorders. The latter include lithiasis, stenosis and megaduct. In this paper, we describe a clinical case of bilateral megaduct, a rare pathology, using sialo-MRI imaging and a conservative diagnostic-cum-therapeutic technique, sialendoscopy with dilation followed by catheterization. CLINICAL CASE Our female patient presented oversized parotids with an unsightly deformation of the face (parotid ducts visible beneath the skin) and itchy cheeks, from which she had suffered for several years. Sialo-MRI revealed bilateral hypertrophied parotid saliva glands. We opted to perform diagnostic sialendoscopy to explore the branches of the salivary gland system and found ducts shaped like strings of sausages associated with mucous plugs. The treatment procedure was combined with rinsing of both parotid ducts in physiological serum followed by initiation of antibiotic-corticotherapy within the saliva ducts and, lastly, by placement of transpapillary drains, which were left in place for 10 days. Immediately following the procedure, the patient felt a considerable improvement regarding both local discomfort and her cheek deformation. Postoperative control at 10 weeks by sialo-MRI confirmed the reduction of the dilation of the salivary ducts. At 3 months, the patient continued to display a marked clinical improvement despite her saliva retaining a thick consistency. She no longer suffered from pruritis or deformation of the cheeks. DISCUSSION Sialendoscopy could become the reference treatment tool since it is both efficient and conservative. Duration of her postoperative catheterization remains to be defined.
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Affiliation(s)
- L Vatin
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J M Foletti
- Oral, Maxillo-Facial & Plastic Surgery Department, Hospital Nord, chemin des Bourrelys, 13015 Marseille, France; Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France
| | - C Collet
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - A Varoquaux
- Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France
| | - C Chossegros
- Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Parole et Langage Laboratory (LPL), UMR 6057, Pr N.N'Guyen, 13100 Aix-en-Provence, France
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7
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Gardhouse S, Guzman DSM, Petritz OA, Mok MY, Mohr FC, Tong N, Sadar M, Salinger ED, Steffey MA. Diagnosis and Treatment of Sialectasis in a Domestic Rabbit (Oryctolagus cuniculus). J Exot Pet Med 2016. [DOI: 10.1053/j.jepm.2015.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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8
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Lee DH, Yoon TM, Lee JK, Lim SC. Congenital dilatation of Stensen's duct in siblings. Int J Pediatr Otorhinolaryngol 2015; 79:1952-4. [PMID: 26347191 DOI: 10.1016/j.ijporl.2015.08.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/19/2015] [Accepted: 08/21/2015] [Indexed: 11/28/2022]
Abstract
Congenital dilatation of the Stensen's duct is an extremely rare disease, which may have a hereditary background. However, there are no reports about the familial occurrence of congenital Stensen's duct dilatation. Herein, we present the first case of congenital dilatation of Stensen's duct in siblings. Therefore, we suggest that congenital dilatation of the Stensen's duct is an extremely rare hereditary disorder.
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Affiliation(s)
- Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Tae Mi Yoon
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, South Korea.
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Abstract
Patients with salivary gland disease present with certain objective and/or subjective signs. An accurate diagnosis for these patients requires a range of techniques that includes the organized integration of information derived from their history, clinical examination, imaging, serology, and histopathology. This article highlights the signs and symptoms of the salivary gland disorders seen in the Salivary Gland Center, and emphasizes the methodology used to achieve a definitive diagnosis and therapy.
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Affiliation(s)
- Louis Mandel
- Department of Oral and Maxillofacial Surgery, Salivary Gland Center, Columbia University College of Dental Medicine, 630 West 168th Street, New York, NY 10032, USA.
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10
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Lohia S, Joshi AS. Idiopathic sialectasis of the Stensen's duct treated with marsupialisation. BMJ Case Rep 2013; 2013:bcr2013201548. [PMID: 24234433 PMCID: PMC3830397 DOI: 10.1136/bcr-2013-201548] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Sialectasis is an uncommon medical condition of the salivary glands. Conservative treatments of sialectasis include repeated aspiration, compression, dilation of the papilla and stent placement. This is the first reported case that we know of, using marsupialisation for distal sialectasis. Our case highlights the diagnostic and therapeutic challenges posed by sialectasis and demonstrates the efficacy of marsupialisation for distally based sialectasis when conservative treatments fail.
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11
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Yoruk O, Kılıc K, Kantarcı M. "Mustache sign" due to Stensen duct dilation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e514-6. [PMID: 24209996 DOI: 10.1016/j.oooo.2013.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/31/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
Abstract
An 80-year-old woman presented with a 5-year history of painless swellings of the left and right cheeks. The degree of swelling did not change with mastication. On palpation, the cheeks were soft, well defined, and movable. Compression and massage of the swollen areas caused increased salivary discharge from the orifices of the Stensen ducts. Three-dimensional computed tomography showed well-bordered, 15- to 20-mm wide, bilateral, tube-like dilatations of the ducts. The ductal origin of the swellings was explained to the patient, but she refused invasive procedures, thus no sialogram or surgical procedure was performed. We describe the clinical and radiographic features of a case of bilateral, congenital Stensen duct dilatation with bilateral swelling of the cheeks.
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Affiliation(s)
- O Yoruk
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
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12
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Wang Y, Yu GY, Huang MX, Mao C, Zhang L. Diagnosis and treatment of congenital dilatation of Stensen's duct. Laryngoscope 2011; 121:1682-6. [DOI: 10.1002/lary.21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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13
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Sánchez R, Navarro I, Chamorro M, Cebrián J, Burgueño M. Sialoectasia crónica del conducto de Stenon: a propósito de un caso. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1130-0558(10)70032-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Yoon YH, Rha KS, Choi JW, Koo BS. Sialectasis of Stensen's duct: an unusual case of recurrent cheek swelling. Eur Arch Otorhinolaryngol 2008; 266:573-6. [PMID: 18478245 DOI: 10.1007/s00405-008-0702-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2007] [Accepted: 04/29/2008] [Indexed: 10/22/2022]
Abstract
Sialectasis of Stensen's duct is an uncommon condition of the salivary gland featuring dilation of the parotid duct. Various surgical and non-surgical treatment modalities have been reported as treatment for Stensen's duct stenosis. In this report, a rare case of sialectasis with fusiform dilatation of the parotid duct is presented, which was corrected by a simple and easy surgical technique creating a new opening in the buccal mucosa.
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Affiliation(s)
- Yeo-Hoon Yoon
- Department of Otolaryngology, Head and Neck Surgery, Chungnam National University College of Medicine, Cancer Research Institute, Daejeon, South Korea
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Mandel L. The Grossly Dilated Stensen’s Duct: Case Reports. J Oral Maxillofac Surg 2007; 65:2089-94. [PMID: 17884545 DOI: 10.1016/j.joms.2006.03.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 03/01/2006] [Indexed: 10/22/2022]
Affiliation(s)
- Louis Mandel
- Salivary Gland Center, Columbia University College of Dental Medicine, USA.
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