title: A case of bilateral megaducts: Diagnostic and treatment methods.
abstract: BACKGROUND
  The pathology of the saliva glands comprises both tumoral and obstructive disorders. The latter include lithiasis, stenosis and megaduct. In this paper, we describe a clinical case of bilateral megaduct, a rare pathology, using sialo-MRI imaging and a conservative diagnostic-cum-therapeutic technique, sialendoscopy with dilation followed by catheterization.
  
  
  METHODS
  Our female patient presented oversized parotids with an unsightly deformation of the face (parotid ducts visible beneath the skin) and itchy cheeks, from which she had suffered for several years. Sialo-MRI revealed bilateral hypertrophied parotid saliva glands. We opted to perform diagnostic sialendoscopy to explore the branches of the salivary gland system and found ducts shaped like strings of sausages associated with mucous plugs. The treatment procedure was combined with rinsing of both parotid ducts in physiological serum followed by initiation of antibiotic-corticotherapy within the saliva ducts and, lastly, by placement of transpapillary drains, which were left in place for 10 days. Immediately following the procedure, the patient felt a considerable improvement regarding both local discomfort and her cheek deformation. Postoperative control at 10 weeks by sialo-MRI confirmed the reduction of the dilation of the salivary ducts. At 3 months, the patient continued to display a marked clinical improvement despite her saliva retaining a thick consistency. She no longer suffered from pruritis or deformation of the cheeks.
  
  
  CONCLUSIONS
  Sialendoscopy could become the reference treatment tool since it is both efficient and conservative. Duration of her postoperative catheterization remains to be defined.
authors.affiliation: Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: loraine.vatin@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Vatin
authors.affiliation: Oral, Maxillo-Facial & Plastic Surgery Department, Hospital Nord, chemin des Bourrelys, 13015 Marseille, France; Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Foletti
authors.affiliation: Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France.
authors.forename: C
authors.initials: C
authors.lastname: Collet
authors.affiliation: Radiology department, Hospital de La Conception, 147, Boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France.
authors.forename: A
authors.initials: A
authors.lastname: Varoquaux
authors.affiliation: Oral and Maxillofacial Department, pôle PROMO, Hospital de La Conception, 147, boulevard Baille, 13005 Marseille, France; Aix-Marseille University, Jardin du Pharo, 58, boulevard Charles-Livon, 13284 Marseille cedex 07, France; Parole et Langage Laboratory (LPL), UMR 6057, Pr N.N'Guyen, 13100 Aix-en-Provence, France.
authors.forename: C
authors.initials: C
authors.lastname: Chossegros
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008776:Methylprednisolone Hemisuccinate / Q000627:therapeutic use; D008875:Middle Aged; D019152:Paracentesis; D010305:Parotid Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018987:Salivary Ducts / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome; D014470:Umbilical Cord / Q000637:transplantation
chemical_list: D008776:Methylprednisolone Hemisuccinate; D000658:Amoxicillin
keywords: Megaduct; Sialendoscopy; Stent