Signs and symptoms:
- Strictures are the second most common cause of chronic obstructive sialadenitis, after salivary stones.
- Strictures may give rise to the mealtime syndrome, causing pain and swelling of the involved salivary gland upon salivary stimulation with the sight, smell, and taste of food.
- In some cases, there is irregular and intermittent pain and swelling of the gland not related to meal times.
- Swelling is typically present upon waking or occurs before the first meal of the day.
- After several hours, the swelling goes down suddenly with a rush of foul-tasting saliva.

Causes:
- Chronic inflammation of the duct system (sialodochitis) can cause segments of the duct to narrow due to fibrosis, while others dilate.
- Saliva stagnates and forms a mucus plug behind the stricture during sleep when the salivary output of the parotid is reduced.
- The mucus plug becomes stuck in the stricture when salivary secretion is stimulated.
- The backlog of saliva behind the blockage causes swelling, and the increased pressure inside the gland causes pain.
- When the mucus plug is dislodged, the built-up saliva is released and the swelling subsides.

Diagnosis:
- Strictures are often diagnosed based on difficulty with insertion and manipulation during sialendoscopy.
- Sialography or ultrasound can also be used for diagnosis.

Treatment:
- Treatment options include endoscopic dilation or surgery.
- Endoscopic dilation is the primary treatment method.
- If endoscopic dilation fails, surgery may be necessary.

Epidemiology:
- Approximately 20% of individuals with mealtime syndrome have strictures upon sialography.
- Strictures seem to be more common in females, although the reasons are unknown.