The Therapeutic Value of Ultrasound-Guided Irrigation in Sialodochitis: A Case Report

  • Ahn, Chi-Hyuk (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital) ;
  • Auh, Q-Schick (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital) ;
  • Lee, Yeon-Hee (Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital)
  • 투고 : 2018.05.24
  • 심사 : 2018.06.19
  • 발행 : 2018.06.30


In the present case study, we reported a female patient with sialodochitis fibrinosa in which a conservative ultrasound (US)-guided irrigation method was used to relieve her symptoms. A 30-year-old female patient visited Kyung Hee University Dental Hospital with chief complaints of persistent swelling and discomfort in the left facial area. Her primary symptom was facial swelling that was accompanied by neuropathological symptoms, such as itching, tingling, and warmth that usually continued for 3 to 4 days. During clinical examination of orofacial area, mild swelling and fever were noted in the left face including parotid region, and mild induration could be felt at the corresponding site; sialadenitis of the left parotid gland was tentatively diagnosed. Herein, we performed intraductal irrigation of the left parotid gland in three times per month and prescribed some medication. Thus, her signs and symptoms have been improved, and she did not experience a recurrence for 12-month follow-up to date. This study can support the usefulness of the US-guided irrigation method to treat the sialodochitis fibrinosa without remarkable side effects.


  1. Ugga L, Ravanelli M, Pallottino AA, Farina D, Maroldi R. Diagnostic work-up in obstructive and inflammatory salivary gland disorders. Acta Otorhinolaryngol Ital 2017;37:83-93.
  2. Ray A, Burgin SJ, Spector ME. A rare case of Kussmaul Disease (Sialodochitis Fibrinosa). J Case Rep Med 2015;4:235894.
  3. Bialek EJ, Jakubowski W, Zajkowski P, Szopinski KT, Osmolski A. US of the major salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. Radiographics 2006;26:745-763.
  4. Baer AN, Okuhama A, Eisele DW, Tversky JR, Gniadek TJ. Eosinophilic sialodochitis: redefinition of 'allergic parotitis' and 'sialodochitis fibrinosa'. Oral Dis 2017;23:840-848.
  5. Owen ER, Banerjee AK, Kissin M, Kark AE. Complications of parotid surgery: the need for selectivity. Br J Surg 1989;76:1034- 1035.
  6. Koch M, Iro H. Salivary duct stenosis: diagnosis and treatment. Acta Otorhinolaryngol Ital 2017;37:132-141.
  7. Epker BN. Obstructive and inflammatory diseases of the major salivary glands. Oral Surg Oral Med Oral Pathol 1972;33:2-27.
  8. Marchal F, Dulguerov P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg 2003;129:951-956.
  9. Hayashi K, Onda T, Ohata H, Takano N, Shibahara T. Case of suspected sialodochitis fibrinosa (Kussmaul’s disease). Bull Tokyo Dent Coll 2016;57:91-96.
  10. Flores RBJ, Brea AB, Sanabria SAA, et al. Sialodochitis fibrinosa (kussmaul disease) report of 3 cases and literature review. Medicine (Baltimore) 2016;95:e5132.
  11. Chikamatsu K, Shino M, Fukuda Y, Sakakura K, Furuya N. Recurring bilateral parotid gland swelling: two cases of sialodochitis fibrinosa. J Laryngol Otol 2006;120:330-333.
  12. Bates D, O'Brien CJ, Tikaram K, Painter DM. Parotid and submandibular sialadenitis treated by salivary gland excision. Aust N Z J Surg 1998;68:120-124.
  13. Bartlett LJ, Pon M. High-resolution real-time ultrasonography of the submandibular salivary gland. J Ultrasound Med 1984;3:433-437.