What is salivary duct stenosis?
Duct stenosis is a narrowing of the salivary duct that restricts saliva flow. It can follow repeated inflammation, prior infection, autoimmune conditions, trauma, or rarely after duct cannulation. Patients describe intermittent swelling during meals, a sense of tightness, and sometimes sialadenitis without obvious stones.
How we diagnose stenosis
- History & Examination: Timing of swelling (often around meals) and palpation of the duct/gland.
- Ultrasound: First-line, shows duct calibre, residual saliva, and any small stones.
- MR sialography or contrast sialography: Maps strictures and side branches.
- Diagnostic Sialendoscopy: Gold standard for direct visualization; we can treat during the same sitting.
Endoscopic treatment options
- Gentle Dilation: Serial probes or balloon catheters widen the narrowed segment.
- Irrigation: Warm saline flushes mucus plugs and debris.
- Intraductal Medication: Steroid or anti-inflammatory irrigation to calm the lining.
- Temporary Stenting: Keeps the duct open during healing.
Outcomes and prevention of recurrence
Most patients report rapid relief and fewer attacks. We teach home care: hydration, salivary massage, sialogogues, and oral hygiene to prevent blocked saliva duct episodes. In recurrent or long-segment stenosis, staged dilations may be required. Gland removal is rarely needed when modern endoscopic care is available.
Risks
Transient swelling, minor bleeding, infection, or duct wall irritation can occur but are generally self-limiting. We use small-calibre scopes, careful energy settings, and protective stents when appropriate.
If scans haven't shown a stone but symptoms persist, ask about endoscopic evaluation for parotid duct obstruction or submandibular blockage. Early treatment restores function and prevents chronic damage.