Equine Sialolithiasis of the Distal Parotid Duct. Retrospective Study on 4 Cases

Author(s): Diakakis N, Karadima V

Sialolithiasis is an infrequently encountered condition in equids, although it occurs more frequently in equine species than other domestic species. Sialoliths appear smooth or slightly spiculated, and gray, yellowish, or white. The most common presentation is within the parotid duct, usually at its most rostral portion, just before it opens into the vestibule opposite the third upper cheek tooth with very few cases affecting the mandibular duct. Typically, a non-painful, movable, firm structure is palpable on the lateral aspect of the face near the rostral end of the facial crest, and it can be present for many years before additional clinical signs develop and lead to veterinary attention. In total, three horses and one donkey (four equines) were included in this study. All animals were in good clinical condition. None of these cases showed signs of concurrent sialadenitis or had problems eating. A detailed teeth examination showed severe enamel overgrowths on all arcades. In all cases, diagnosis of sialolithiasis was based on clinical presentation and palpation and was confirmed by surgically removing the sialolith. All sialoliths were removed with the animals standing under sedation and local anesthesia. In one case, a decision was made to remove the sialolith through a transcutaneous approach with ligation of the parotid duct at its rostral end. For the remaining three cases the transoral technique was elected. Although the size of the removed sialoliths varied, they ranged from 6 to 8cm in length. All four sialoliths were dissected, with no evidence of a plant or any other foreign material found in any of them. The first horse, in which the transcutaneous excision was elected, developed a marked distention of the parotid duct. Although the incision wound closed nicely, a visible blemish was created because of the retrograde distention of the parotid duct. In the remaining three animals, which were operated via the transoral technique, improvement was immediately seen following surgery and no blemishes or any other complications were noted. On patient follow-up via telephone 3 years post-operatively, no signs of sialolith re-growth were noted by the owners. Based on the results of this study, it is recommended that sialoliths should be identified as early as possible at the course of the disease, before they grow substantially in size, and that the transoral surgical excision is the treatment of choice provided that the sialolith is accessible orally.

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