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Objective: To study the sialographic changes and to compare the changes with sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis (COP)., Methods: This study involved 27 patients with a long history of parotid swelling. All patients were examined by X-ray, sialography, and were diagnosed as COP without sialolithiasis. Sialoendoscopy was used to observe the ductal system and irrigation treatment performed. The irrigated liquid was centrifuged and the deposits of fluid were stained and observed under microscopy. The sialographic changes were classified as previous studies and compared with sialoendoscopic and irrigation fluid findings., Results: The sialographic changes of COP in 27 patients included 9 cases with type I, 5 cases with type II, 9 cases with type III and 3 cases with type IV changes, 1 case was normal. Marked obstructive factors such as stricture of ductal system were revealed in 21 cases on the sialogram. Sialoendoscopic examination showed that the ductal system was filled with fiber-like substances and hyperaemia of ductal wall in all cases. While few and thin fiber-like substances were found in the COP with sialographic type I and type II changes, many thick wadding or mass fiber-like substances were revealed in COP with sialographic type III and IV changes. Microstones were found in 2 COP with sialographic type III changes which were stained and identified by microscopy. Foreign body (drug bar) was found in one COP with sialographic type I changes with sialoendoscopy. Irrigation fluid examination showed fiber-like substance was composed of desquamative duct epithelial cells, neutrophil, lymphocytes, acidophile. Some epithelial cells were found in two microliths., Conclusions: The pathological basis of fiber-like substance on sialoendoscopy is desquamative duct epithelial cells. Fiber-like substance in the lumen of ductal system is considered as one of the obstructive factors in COP. Sialoendoscopic findings is related to sialographic changes.

This study presents a study on 23 patients with chronic obstructive parotitis (COP) in whom the sialographic changes are related to the clinical and histopathological features. The sialographic changes are divided into 4 types. The stimulated parotid flow rate (SPFR) is normal in sialography Type I patients, while SPFR is significantly reduced in Type II, III, and IV patients, as compared with healthy persons. The changes under light microscope consist of irregular dilatation and chronic inflammation of main and branching ducts with saliva deposits in the enlarged luminal system. Ultrastructural changes include degeneration of ductal epithelial cells, marked proliferation of periductal fibrous tissue, and moderate electron-dense deposits in the lumen of the dilated peripheral ducts. The extent of the histopathologic changes largely parallel the severity of the sialographic changes. These findings indicate that COP is a common inflammatory disease and that the sialographic classification reflects the severity of the disease.

Sequential quantitative scintigraphy of parotid glands was performed in 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis, 37 with Sjögren's syndrome, 4 with sialadenosis and 30 normal controls. Uptake function was normal, but excretion was retarded in recurrent parotitis in childhood. Chronic obstructive parotitis exhibited that excretion was obstructed and the uptake and excretion function between bilateral parotids was marked different. In Sjögren's syndrome, uptake was very low and excretion was heavily delayed. Sialadenosis showed that excretion was retarded and uptake function was not definitely involved. The possible mechanism of the scintigraphical features were analyzed combined with the histopathological findings.