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Buccinator window anomaly

P J Lamey1, A M Darwazeh

  • 1School of Clinical Dentistry, The Queen's University of Belfast, Royal Victoria Hospital, N. Ireland, UK.

Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology
|October 28, 1998
PubMed
Summary

Recurrent parotid swelling in four patients was investigated using advanced sialography. This technique revealed high initial duct filling pressures, suggesting a functional issue rather than structural abnormality.

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Area of Science:

  • Salivary Gland Imaging
  • Diagnostic Techniques in Otolaryngology

Background:

  • Recurrent parotid swelling can be a challenging clinical presentation.
  • Previous sialography using manual injection failed to identify structural abnormalities in these patients.

Purpose of the Study:

  • To investigate the underlying cause of recurrent parotid swelling in patients with normal findings on conventional sialography.
  • To evaluate the utility of continuous-infusion pressure-monitored sialography in diagnosing parotid gland disorders.

Main Methods:

  • Four patients with recurrent parotid swelling underwent repeat sialography.
  • A continuous-infusion pressure-monitored system was employed for the sialography procedure.
  • Morphological assessment of the duct system and gland was performed.

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Main Results:

  • Sialography demonstrated initially very high filling pressures (>200 mmHg) in all patients.
  • A rapid reduction in pressure followed, leading to a more normal filling pattern.
  • The parotid duct system and glands appeared morphologically normal.
  • Treatment with acrylic appliances and intraductal catheters showed some success.

Conclusions:

  • Recurrent parotid swelling may be associated with abnormal ductal pressure dynamics rather than structural defects.
  • Continuous-infusion pressure-monitored sialography is a valuable tool for diagnosing functional parotid gland issues.
  • Further investigation into the management of pressure-related parotid swelling is warranted.