Sialoendoscopic and irrigation findings in chronic obstructive parotitis.

Objectives/hypothesis: To study the sialographic changes related to sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis.

Study Design: The sialographic changes were classified according to previous studies and related to sialoendoscopic and irrigation fluid findings.

Methods: This study included 26 patients with a long history of parotid swelling. All patients were examined by radiography and sialography and were diagnosed as having chronic obstructive parotitis without sialolithiasis. Sialoendoscopy was used to observe the ductal system and perform an irrigation treatment. The irrigated liquid was centrifuged, and the fluid deposits were stained and observed using light microscopy.

Results: In all cases, sialoendoscopic examination showed the ductal system was filled with fiber-like substances and hyperemia of the ductal wall. Although a few of the thin and short fiber-like substances were found in the chronic obstructive parotitis patients with sialographic type I and type II changes, many thick and long wadding or lumpy fiber-like substances were revealed in chronic obstructive parotitis patients with sialographic type III and IV changes. Microstones were found in two chronic obstructive parotitis patients with sialographic type III changes, which were stained and identified using light microscopy. Irrigation fluid examination showed that the fiber-like substance was composed of desquamative duct epithelial cells, neutrophils, lymphocytes, and acidophils. Also, some epithelial cells were found in two microliths.

Conclusions: Sialoendoscopy can provide direct and more detailed observation of the ductal system compared with sialography. Fiber-like substances in the lumen of the ductal system are considered one of the obstructive factors associated with chronic obstructive parotitis.