Patient with history of parotitis and sialolithiasis status post endoscopic removal of stones. Now with right parotid cutaneous fistula and infection, recurrent abscess in the past 3 months. There has been interval removal of the right parotid duct calculi. However, there is now a tract that extends from the overlying skin to the and decreased inflammation involving the junction between the parotid gland and parotid duct. There is minimal residual diffuse enhancement of the otherwise fat-replaced right parotid gland and overlying subcutaneous tissues. There appears to be a 2 mm diameter low signal structure in the anterior right parotid gland. There is no evidence of drainable fluid collections. There are mildly prominent right parotid lymph nodes, which are likely reactive. The left parotid gland and submandibular glands appear to be unremarkable. There is interval resolution of the fluid and mucosal thickening within the right maxillary sinus. There is a ovoid cystic lesion in the left auricle, which may represent an inclusion cyst. There is a partially-characterized left supraclinoid internal carotid artery aneurysm that measures up to approximately 15 mm.
1. Interval removal of the right parotid duct calculi with development of a parotid-cutaneous fistula. Minimal residual diffuse enhancement of the otherwise fat-replaced right parotid gland and overlying subcutaneous tissues related to parotitis.2. Probable calculus within the anterior right parotid duct measuring 2 mm in diameter.3. Partially-characterized left supraclinoid internal carotid artery aneurysm that measures up to approximately 15 mm.