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Parotid Sialogram Post Irradiation Stricture

last modified on: Fri, 01/05/2024 - 12:58

return to: Sialograms and Sialography

Patient with left parotid swelling status post chemotherapy and radiation treatment. Lidocaine was placed over the left parotid gland papilla. 0.018 inch wire was advanced into the left parotid gland. A 22-gauge angiocatheter was advanced over the wire and into the left parotid gland duct. Approximately 1cc of Isovue-370 contrast was instilled under fluoroscopic guidance. Multiple fluoroscopic images were obtained during contrast injection into the left parotid gland duct. Fluoroscopic images during contrast injection shows normal sized distal right Stensen's duct with eventual smooth tapering to occlusion in the midportion of the main duct. The smooth tapered occlusion involving the mid left Stensen's duct is approximately 2.5 cm from the angiocatheter tip. There are no filling defects seen within the left main duct. The intraglandular ductal architecture was not seen on this exam due to the main duct obstruction.

Normal right parotid duct

Stricture left parotid duct

Instilled contrast is unable to pass beyond stricture

Two short lines show normal duct; long line shows stricture