Parotitis
Parotitis is an inflammation of the parotid glands, located inside each cheek, and can affect one or both glands. This condition is often associated with various causes, including viral infections like mumps, which has become less common due to widespread vaccination. Other viral agents, such as the Epstein-Barr virus and cytomegalovirus, as well as blockages in saliva flow caused by salivary stones or other conditions, can also lead to parotitis. The symptoms include swelling in front of the ears, dry mouth, and facial pain, particularly during eating. Diagnosis typically involves a physical examination and may include imaging tests or fluid analysis. Treatment focuses on maintaining good oral hygiene, managing underlying conditions, and in some cases, medical procedures. Preventative measures include regular dental care and hydration to promote saliva flow. Parotitis can lead to more serious complications if left untreated, emphasizing the importance of seeking medical advice when symptoms arise.
Parotitis
- ANATOMY OR SYSTEM AFFECTED: Glands, mouth
- ALSO KNOWN AS: Salivary gland infection, sialadenitis
Definition
Parotitis causes swelling in one or both parotid glands, the two large salivary glands inside each cheek over the jaw and in front of each ear. Usually, the problem goes away by itself, but some cases require treatment. If swelling or other symptoms occur on this part of the face, one should see a doctor.
Causes
A variety of factors can lead to an inflamed parotid gland. They include a viral infection such as mumps, which is the main viral cause of parotitis (this virus is rare today because of vaccines), and acquired immunodeficiency syndrome (AIDS). Other viral infections that might cause parotitis include the Epstein-Barr virus (EBV), cytomegalovirus (CMV), influenza, human immunodeficiency virus, and coxsackievirus.
Another cause of parotitis is a blockage of saliva flow, which can lead to a bacterial infection. Causes of this blockage include a salivary stone in the parotid gland, a mucous plug in a salivary duct, a tumor (usually benign), Sjögren’s syndrome (an autoimmune disease), sarcoidosis, malnutrition, and radiation treatment of head and neck cancer.
Other conditions can cause the parotid glands to become enlarged but not infected, including diabetes, alcoholism, and bulimia. Bacterial parotitis can occur in individuals with reduced salivary flow. Certain medications, radiation therapy, and injury may also cause parotitis.
Risk Factors
The risk factors for parotitis are poor oral hygiene; not being vaccinated against mumps; having human immunodeficiency virus infection, having AIDS, Sjögren’s syndrome, or diabetes, malnutrition; alcoholism; and bulimia. Also, persons aged sixty-five and older are at higher risk. Dehydration, taking certain medications, medical conditions, trauma to the head or neck, recent dental surgery, and risky lifestyle choices may also increase risk.
Symptoms
People with any of the symptoms should not assume those symptoms are caused by parotitis. These symptoms may be caused by other health conditions. To determine the cause of the following symptoms, one should see a doctor: swelling in front of the ears, below the jaw, or on the floor of the mouth; dry mouth; strange or foul taste in mouth; pus draining into the mouth; mouth or facial pain, especially when eating or when opening the mouth; and fever, chills, and other signs of infection. If parotitis recurs, it can cause severe neck swelling and destroy the salivary glands.
Screening and Diagnosis
A doctor will ask about symptoms and medical history and will perform a physical exam. This may be enough to make a diagnosis. Tests may include removing fluid from the gland and checking it for signs of infection; X-rays (a test that uses radiation to take a picture of structures inside the body, in this case, to look for salivary stones); ultrasound (a test that uses sound waves to take pictures of structures inside the body); and a computed tomography (CT) scan (a detailed X-ray picture that identifies abnormalities of fine tissue structure). Sialography, which involves using contrast dye on salivary glands, magnetic resonance imaging (MRI), sialendoscopy, fine-needle aspiration biopsy, and laboratory tests, are also used to diagnose parotitis.
Treatment and Therapy
Treatment options include good oral hygiene, such as flossing and thorough tooth brushing, at least twice a day. Warm salt-water rinses can help keep the mouth moist, and quitting smoking may also help.
Antibiotics, used to control bacterial infections only, are ineffective for viral infections such as parotitis. Other medications, which treat underlying conditions such as Sjögren’s syndrome or AIDS, may be prescribed instead. Anti-inflammatory drugs may be recommended to help manage swelling and pain. Antiviral medications and corticosteroids may also be considered. Procedures, such as stone removal, abscess drains, and parotidectomy, may be necessary. Increasing saliva flow may be all that is needed to remove a mucous plug.
Prevention and Outcomes
To help reduce the chance of getting parotitis, one should get treatment for infections, get regular dental care, drink increased amounts of fluids, and suck on sugarless candy or chew sugarless gum to increase the flow of saliva.
Bibliography
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"Saliva & Salivary Gland Disorders." National Institute of Dental and Craniofacial Research, Oct. 2024, www.nidcr.nih.gov/health-info/saliva-salivary-gland-disorders. Accessed 12 Oct. 2024.
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