Parotid duct

The parotid gland is a tube-like canal, around 7 cm in length, which starts from the front portion of the parotid gland located next to the ear and then extends all the way to the mouth. After it leaves the parotid gland, the parotid duct pass the masseter, crosses into the buccinator, keeps moving forward obliquely for a short distance between the oral mucous membrane and the buccinator, and then opens out on the mouth’s surface located near the cheek via a tiny opening present on the opposite end of the 2nd upper molar tooth.

The parotid duct is also known as Steno’s duct, named after the Dutch anatomist Nicolas Steno who first described the duct in detail in the year 1660. Another name for the parotid duct is ‘Stensen’s duct.’

Parotid salivary glands

The oral cavity has many salivary glands. Some occur on the tongue and lips while others lie in the palate and the cheeks. A majority of them are very tiny. Three main pairs of salivary glands are located below each ear. The biggest of these glands are called parotid salivary glands or parotid glands.

The parotid duct may suffer from inflammation, swelling, and other conditions. The causes along with the associated symptoms and treatments are discussed below.

Symptoms of swollen parotid duct

Swollen parotid duct may occur due to a variety of different causes, including salivary gland stones to varied infections and diseases. The accompanying symptoms thus differ as per the underlying cause. Some of the common signs and symptoms of swollen parotid duct are listed below:

• Continuous and persistent pain in the ears
• Swelling under the ears; it may occur on both sides of the face or just on one side.
• The side of the face or just above the neck may experience inflammation
• The mouth floor or underside of the jaw may become swollen
• Affected side of the face may elicit complete or partial loss of motion/movement.
• Pain in ears when eating
• Difficulties in opening the mouth
• Foul or abnormal taste in the mouth
• Problems in swallowing
• Dry eyes
• Throat pain
• Loss or lack of appetite
• High or low grade fever
• Pain in the face
• Muscle soreness
• Nausea
• The affected gland may be painful
• Loss of jaw angle
• Men and teen boys may experience swelling of the testes

Causes of swollen parotid duct

Some of the common causes of swollen parotid duct are as follows:

• Salivary gland stones: Saliva is carried from the parotid glands by the ducts and emptied near the upper molars in the mouth. Occasionally, calcified stones may form in the parotid duct which then causes obstruction leading to infection and swelling of the ducts. Small stones are usually asymptomatic, but larger stones can obstruct the parotid gland and cause pain, infection, inflammation, and swelling of the duct.
  • The exact cause of stone formation is not known, but it occurs due to thickened or decreased saliva production, which in turn can be triggered by a variety of risk factors like salivary glands trauma, poor diets, dehydration, and use of certain medicines like hypertension, bladder control, or psychiatric drugs. Salivary gland stones generally affect adults.
  • Small stones pass out on their own or via home remedies like sucking on sour candies or a lemon. Doctors may also push or massage a small stone out from the parotid duct. Large stones require an oral incision for removal; less-invasive techniques like sialendoscopy may also be used to remove the stones.
• Mumps: It is caused due to a viral infection and mostly affects children, especially in underdeveloped nations. Mumps can cause parotid ducts swelling as well as inflammation of the adjacent epithelial tissues. Lack of prompt treatment can result in several health complications, including ear dysfunction and even partial to total deafness. The contagious disease can be prevented via the MMR vaccine.
• Tumors: Sometimes, a malignant or benign tumor may form in the parotid gland which then exerts pressure on the parotid duct or causes obstructions in the flow of saliva, thereby resulting in swelling of the duct or the gland. When only one side of the face is swollen, then it is more likely to be caused due to a tumor. Non-cancerous tumors can be removed via surgery, while malignant tumors may also require radiation therapy and/or chemotherapy.
• Bacterial infection: Bacterial infection of the parotid duct generally occurs due to poor oral hygiene. It can also affect dehydrated and seriously ill individuals. Infections can also cause enlargement of the surrounding lymph nodes, eventually leading to swollen parotid ducts. Bacterial infections are treated with antibiotics.
• Abnormal parotid ducts: Abnormal narrowing of the parotid duct at certain areas may also cause blockages in the free flow of saliva, thereby causing swollen parotid duct.
• Varied diseases: Sjögren’s syndrome, HIV/AIDS and other illnesses marked by abnormal functioning of the immune system can also cause parotid duct problems. Alcohol abuse, rheumatoid arthritis, sarcoidosis, and diabetes can cause enlargement of the parotid glands, subsequently causing complications of the parotid ducts.