Parotid Duct Cyst- Our Experience (In a Rural Medical College)

Abstract

BACKGROUND Parotid duct sialocele is a rare entity. Patients presented with mostly painless, cystic swelling over the cheek encroaching to the parotid region. Diagnosis was done by FNAC and MR sialogram which revealed that the swellings were due to parotid duct sialocele. That swelling was due to obstruction to the parotid duct by sialolithiasis, trauma, etc. Some of those patients had h/o chewing of areca nuts and betel quid. We found in those cases oral submucosal fibrosis, but we did not find such association in any literature. Many treatment options available for e.g. repeated aspirations, marsupialisation etc. but mostly all were associated with recurrence. We found in literature that the foolproof treatment is superficial parotidectomy. In our cases also superficial parotidectomy was the best treatment option having no recurrence. MATERIALS AND METHODS We report twenty-two cases who presented with parotid duct sialocele to our OPD at BSMC, Bankura. We examined the cases and diagnosed those cases by several methods. We instituted several treatment options. RESULTS Initially we did aspiration in all patients with parotid duct sialocele, but out of the twenty-two cases recurrence occurred in twenty cases. The patients were disease free for 3-4 weeks. Next, we did repeated aspirations where seventeen cases came with recurrence. Then we opted for marsupialisation with biopsy. These marsupialised patients came back with recurrence after 4-5 months. Out of these seventeen cases, twelve cases were of oral submucosal fibrosis. All the cases with marsupialisation suffered from recurrence who ultimately undergwent superficial parotidectomy with no recurrence for 2-8 yrs. CONCLUSION Oral submucosal fibrosis may be one of causes for parotid duct sialocele which is seen in chronic betel quid and areca nuts chewers. Superficial parotidectomy is the definite treatment for parotid sialocele.