Parotid duct course may not be always straight :The lessons from Dissection Hall

Case scenario :

The parotid glands are the largest salivary glands. The paired parotid glands are formed as epithelial invaginations into the embryologic mesoderm and first appear at approximately 6 weeks' gestation. The glands are roughly pyramidal in shape, with the main body overlying the masseter muscle. The parotid duct is approximately 7 cm long and has a straight course After traveling for a variable distance between the buccinator muscle and the oral mucosa, it enters the oral cavity through a papilla in the buccal mucosa opposite the second maxillary molar.

Fig 1 Anatomy of     Parotid gland 

While in the dissection Hall

During routine dissection of a middle-aged male cadaver, we observed that two parotid ducts emerged from the anterior border of the right parotid gland 6 mm apart.

• These two ducts, the superior (D1) 21 mm and the inferior (D2) 23 mm united with each other near the anterior border of masseter and formed a common duct (D3). 44 mm
• This pattern resembled the English letter ‘Y’ as shown in fig, [2] and we designated it as ‘Y’ pattern of the parotid duct and the two small limbs (D1) and (D2) as “Itoo’s” ducts after the  author's name.
•  The common duct (D3), so formed pierced buccal pad of fat, buccopharyngeal fascia, and buccinators muscle to enter into the vestibule of mouth. 

Fig.2  Y-shaped  Parotid duct left side 

Clinical Presentation of Y shaped anomaly :

•      Preoperative Sialography if done may give diagnosis and will help surgeons operating in the parotid region to plan their surgical procedure.It also reduces the chances of post operative surgical fistulas

Teaching message :

1. Y - Shaped parotid duct is a very rare anomaly. 2. It may or may not present during life time. 3. May present with delayed wound healing and post operative parotid fistulas. 4.Preoperative parotid sialography may detect it and helps in reducing post operative complications. 5. Sound Anatomical knowlege of this region is a must for surgeons.

Click here for Further reading



Contributed By:

Dr. Mohammad Saleem Itoo,
Associate Professor Postgraduate Dept . of Anatomy
Government Medical College Srinagar.
J&K,190010
Email : dr.saleem68@gmail.com


Click here to Submit your teaching case