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Calculi in left parotid gland and enlarged level 2a lymph nodes

Calculi in left parotid gland + enlarged level 2a lymph nodes I am a 26 year female 45 kilos and about 155cm. I have had recurrent bilateral parotid swelling on both sides of the face for about four years. I finally went to an ENT who told me to have a CT Scan of the neck and saliva glands. I have my diagnosis back form the scan it states Small calculi (2) in the body of the left parotid salivary gland. No duct dilation, abcess or mass lesion is seen. Symmetric prominence of Level 2 A lymph nodes measuring up to 2.5cm in length and 1.1cm in width. What does this mean???? i know the first bit it means i have 2 stones in my saliva glands - but why do i have swelling in both glands, and why does the swelling come and go? it isn t painful just uncomfortable and annoying when i look like a chipmunk???? please help
Asked On : Thu, 21 Jul 2011
Answers:  2 Views:  542
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ENT Specialist 's  Response
1. Salivary gland calculi cause obstruction and stasis of the saliva which leads to swelling and infection of your parotid glands (parotitis). Clindamycin is the antibiotic of choice as it is excreted in saliva. Regional lymph nodes draining the glands will normally enlarge and signify spreading infection.

2. The parotid salivary gland is covered by a thick parotid fascia and hence swelling of the parotid gland causes intense pain. The parotid region will also be tense and taut. This means that your parotid swelling is mild.

3. Parotid salivary secretion is mostly 'serous' and not 'mucoid' like the Sub-mandibular salivary glands. Therefore parotid ducts mostly do not develop large stones (as in Sub-mandibular glands) and instead may develop a sand like sludge of debris. The calculi are usually seen in the body of the parotid gland and not in the main ducts. The Parotid (Stensen's) Duct usually opens near the second upper molar tooth.

4. A Sialogram should be done when there is no infection. This will reveal any chronic parotitis, stenosis of the duct/s or 'ectasia' (ballooning) of the duct/s and 'acini' (gland structure). There are stents available for salivary ducts now.

6. Sialendoscopy is a new form of endoscopy for the salivary glands. You may arrange for this to confirm any parotid disease and possibly remove the calculi.

7. Dental infections, dehydration, underlying generalized chronic infections (sarcoidosis, sjogren's syndrome), concurrent medication, autoimmune disorders and other rare disorders (Kussmaul's disease, Sialodochitis ) can lead to recurrent parotitis.
Answered: Fri, 22 Jul 2011
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General Surgeon Dr. Swapnendu Sekhar Ghosh's  Response
welcome to healthcaremagic
the stone causes recurrent infection of the parotid glands giving rise to recurrent swelling and lymph node swelling
please consult surgeon and get yourself examined
there is a condition known as sjogrens syndrome where both the parotid glands and other salivary glands involved and give rise to swellings and other features
consult surgeon and take advice
Answered: Thu, 21 Jul 2011
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