Parotid Duct Obstruction

What is a parotid duct obstruction?

A parotid duct obstruction happens when something blocks saliva from flowing from one of your parotid glands. The parotid glands are two of your salivary glands. They are located on each side of your face by your upper teeth. Saliva helps moisten your mouth and break down food. It also helps protect your teeth.

What causes a parotid duct obstruction?

Your parotid duct may narrow or close off. Your duct may close off because of an injury or previous infection. Minerals in your saliva can harden and form a stone that blocks the duct. Stones may form if you do not produce enough saliva. You also may have a tumor (mass) that blocks the duct.

What are the signs and symptoms of a parotid duct obstruction?

The gland is swollen and may be painful. This often happens when you eat. The swelling may be worse when you first wake up. Sometimes the swelling will come and go.

How is a parotid duct obstruction diagnosed?

Your caregiver will examine your face and mouth. He will ask you about your signs and symptoms. He will feel your parotid gland to learn how swollen it is. He may be able to feel what is blocking the duct. Caregivers may also do the following tests:

• Imaging tests: People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes used for imaging tests. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
  • X-rays: These are pictures taken of your mouth. Caregivers may take x-rays to see where the obstruction is. They may inject dye into the duct to see the obstruction better.
    
    
  • MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.
    
    
  • CT scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your mouth. You may be given dye before the pictures are taken.
    
    
  • Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen.
  
  
• Other tests:
  
  
  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
    
    
  • Endoscopic exam: Caregivers may use an endoscope (a long, thin tube with a light) to explore the narrowed duct. Samples may be taken from the duct and sent to a lab for tests.
    
    
  • Needle aspiration: Caregivers may use a small needle to take fluid out of the duct. The fluid is sent to a lab for tests. These tests will help caregivers plan how best to treat you. The results may show if you have an infection.
    
    
  • Probing: Caregivers may probe the duct with tools to explore the blockage. They will numb the area before the procedure.

How is a parotid duct obstruction treated?

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Duct dilation: Caregivers may use a tube or balloon to widen or cut open the duct.
  
  
• Stone removal: Caregivers may be able to remove a stone in your duct once it has been dilated. They may need to do additional procedures to remove the stone:
  
  
  • Lithotripsy: Caregivers use sound waves to break up the stone. Then they flush the duct to remove the pieces of the stone.
    
    
  • Basket removal: Caregivers remove a mass or stone by hooking it with a basket-shaped tool.
  
  
• Parotid gland removal: If these treatments do not work, caregivers may remove all or part of your parotid gland through surgery.

What are the risks of a parotid duct obstruction?

• If you have an x-ray or a CT scan, you may have an allergic reaction to the dye. Dilation or stone removal may cause pain and swelling or lead to an infection. Procedures may damage the duct or the nerves in your face. You will need a medicine called anesthesia to keep you from feeling pain if you need surgery to remove your parotid gland. This may cause complications. Ask your caregiver for more information about the risks.
  
  
• If you do not treat your parotid duct obstruction, your parotid gland may become infected. This may cause more pain and other health problems. Infection may spread to your blood or bones, which can cause bone weakening. These infections may be life-threatening.

How can I manage a parotid duct obstruction?

• Drinking liquids: Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.
  
  
• Keep your mouth moist: Drink liquids to keep your mouth moist and your salivary glands healthy. Suck on hard candy or chew sugarless gum to get your saliva flowing. Sour and tart flavors such as lemon and orange will help get saliva to flow.
  
  
• Massage your jaw: Massage the area of your swollen gland. This may help relieve swelling and pain.
  
  
• Apply heat: Place a warm, moist cloth on the area.

When should I contact my caregiver?

Contact your caregiver if:

• You have a fever or feel achy.
  
  
• The skin around your parotid gland is red. You may see pus if you push on the gland.
  
  
• Your pain and swelling do not go away, or they get worse.
  
  
• Both sides of your face are swollen.
  
  
• Your mouth and eyes are very dry. You may have problems swallowing.
  
  
• You have questions about your condition or care.

When should I seek immediate help?

Seek care immediately, or call 911 or your local emergency number if:

• You cannot move one side of your face.
  
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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