Parotitis- Symptoms and Treatment
The parotid glands are the saliva-producing glands buried within each cheek. Parotitis is an inflammation of one or both parotid glands. The parotid gland contacts the mandibular ramus and muscles of mastication, which massage the gland during chewing. Parotitis is an inflammation of one or both parotid glands , the major salivary glands located on either side of the face, in humans.Acute suppurative parotitis is a very painful bacterial infection of the gland. Swelling without pain and without infection also consitutes a form of parotitis, which may be acute or chronic. A pure viral or bacterial infection, an autoimmune inflammation, or a combination of these can be the etiology.
Symptoms of Parotitis
Parotitis symptoms usually refers to various symptoms known to a patient, but the phrase Parotitis signs may refer to those signs
- Swollen parotid glands
- Swollen glands near jaw and cheek
- face pain swelling of the parotid glands
- sore throat
- swelling of the temples or jaw (temporomandibular area)
- esticle lump
- scrotal swelling
Causes of Parotitis
The parotid glands may become infected with the same bacteria causing tuberculosis or 'TB'. Treatment is with anti-tuberculous antibiotic therapy.The causes are include
- Parotid gland enlargement
- Amylase levels raised (plasma or serum)
- Facial pain
- In the vast majority of instances, risk factors are unknown.
- Occasionally, drugs such as iodides or guanethidine cause transient swelling of the gland.
- Autoimmune disease causes most cases of chronic parotitis.
- HIV may cause a type of indolent parotitis that suggests an autoimmune process.
- Staphylococcus aureus (historically the most common isolate).
- Haemophilus spp.
- Eikenella corrodens
- Prevotella spp.
- Strictly anaerobic Gram-positive cocci.
- Sjogren's syndrome
- Bacterial infection of parotid gland
- Blocked salivary duct
- Stone in salivary duct
Treatment of Parotitis
The treatment of chronic parotitis is based on the symptoms of the patients which are
- Recurring parotitis, an unpleasant and distressing condition, is managed conservatively in most instances but occasionally requires surgery to end the frequent and severe episodes of infection. The decision for surgery is based on subjective symptoms.
- The swollen inflamed gland makes surgery more difficult, and the incidence of injury to the facial nerve may be slightly higher than for removal of benign tumors.
- The standard treatment is superficial parotidectomy, but if CT scanning or surgery reveals significant involvement of the deep lobe, that portion of the gland is dissected from beneath the nerve.
- Fibrosis makes the tensile strength of the surrounding gland much greater than the nerve itself. Surgery is difficult and expensive. Parotidectomy is still the most acceptable treatment in the United States.
- Tympanic neurectomy: The tympanic nerve, the parasympathetic supply to the parotid gland may be sectioned within the middle ear in hopes of gland atrophy. Success is not uniform, but the magnitude of the surgery is less.
- Ligation of the parotid duct: The duct has been ligated in hopes of causing atrophy of the gland. The duct should be dissected for a short distance within the cheek and severed. The duct should be oversewn to assure that the soft tissue heals. Simple ligation frequently results in recanalization of the duct.