This is a classic presentation of Juvenile Recurrent Parotitis (JRP) — the most common cause of recurrent parotid swelling in children after mumps. It typically presents in children between 3-6 years of age with recurrent unilateral (occasionally bilateral) parotid pain and swelling lasting a few days to a week, often triggered by meals, with partial response to antibiotics. Sialography is diagnostic and characteristically shows punctate/globular sialectasis ("snowstorm" or "cherry blossom" appearance) with normal main duct caliber, due to destruction of acini and peripheral duct dilatation from recurrent low-grade ascending infection/inflammation.

Why Endoscopic Washouts and Antibiotics is Correct

• JRP is a self-limiting condition that generally resolves or significantly improves by puberty, so the mainstay of management is conservative.
• Sialendoscopy (endoscopic ductal washout/lavage) combined with antibiotics and/or intraductal steroid instillation has become the treatment of choice. It mechanically clears inspissated debris and mucus plugs from the ductal system, dilates strictures, and reduces the frequency, severity, and duration of attacks — while preserving the gland.
• This approach is minimally invasive, gland-preserving, and can be repeated safely in children, making it far more appropriate than a destructive or non-curative option.

Why the Other Options are Incorrect

• Prolonged antibiotic bolus doses: Antibiotics alone only treat acute flares symptomatically; they do not address the ductal debris/sialectasis and do not prevent recurrence, so long-term antibiotic use alone is inadequate and promotes resistance.
• Total (conservative) parotidectomy: Surgery is reserved as a last resort for the rare adult patient with severe, debilitating, treatment-refractory disease. In a 6-year-old with JRP, parotidectomy is over-aggressive, carries significant risk to the facial nerve, and is inappropriate first-line management since the condition tends to remit spontaneously with age.
• Radiotherapy: Radiotherapy has no role in a benign, self-limiting inflammatory condition in a child; it would expose the child to unnecessary radiation risk (including risk of secondary malignancy and growth disturbance) without any therapeutic benefit.

Correct answer: Endoscopic washouts and antibiotics — the standard, gland-preserving management of juvenile recurrent parotitis with punctate sialectasis on sialography.