Permanent intramural stenting with polyethylene catheter to resolve parotid salivary duct stenosis secondary to sialolithiasis

Abstract

Sialolithiasis is an uncommon condition of the salivary gland in the horse, primarily affecting the parotid salivary duct. Clinical signs may include salivary stasis within the gland and potential progression to sialadenitis, facial draining tract or a permanent fistula. A 19-year-old Warmblood gelding was referred with septic sialadenitis of the right parotid gland. A 4 cm sialolith was detected radiographically and removed surgically. Although surgery was uneventful and patency of the salivary duct was assessed intraoperatively, mild accumulation of saliva within the gland was noted 1 day later. A stenosis caudal to where the sialolith was lodged was diagnosed through contrast radiography. Balloon dilatation of the stenosis was attempted unsatisfactorily, and a polyethylene catheter was placed and sutured to the oral mucosa to maintain the parotid emptying. A week later, the oral portion of the catheter was chewed by the horse, preventing catheter removal without surgery. Subsequently, ultrasonographic and radiographic re-evaluations were performed routinely to assess the patency of the catheter or complications associated with long-term placement. After 1 year, no salivary stasis in the gland or complications were observed. This is the first description of successful long-term indwelling catheter placement to resolve stenosis of the salivary duct. This procedure may offer a simple, economical and safe option compared to more complicated or invasive techniques previously described in horses, with excellent functional and cosmetic results.