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PubMed1989

Eosinophilic panniculitis associated with chronic recurrent parotitis.

A 37-year-old woman presented with recurrent erythema nodosum-like lesions on her arms and legs that were preceded by chronic recurrent parotitis. Microscopic examination revealed a mixed lobular and septal panniculitis with many eosinophils and multiple eosinophilic flame figures similar to those seen in Wells' syndrome. The dermis was not involved. The classification, differential diagnosis, and possible pathomechanisms of eosinophilic panniculitis are discussed.

Adult↗
PubMedDate not supplied

MRI of chronic recurrent parotitis in childhood.

PURPOSE: Chronic recurrent parotitis (CRP) is a rare inflammatory disease characterized by multiple episodes of unilateral or bilateral parotid inflammation over a period of years. The objective of this study was to evaluate the parotid glands using MRI during acute inflammation as well as during symptom-free intervals. METHOD: Twelve children with a history of CRP were included. Four patients were examined during the acute phase and eight children during symptom-free intervals. MR findings were correlated with the clinical status. RESULTS: Two different patterns were identified by MRI: acute inflammation versus chronic inflammation. Contrast enhancement of the parotid gland indicated acute inflammation. Cysts due to chronic inflammation were encountered in children who suffered multiple episodes of inflammation. CONCLUSION: Our findings suggest that CRP is characterized by recurrent, acute exacerbations of inflammation, resulting in a slowly progressive destruction of the parotid gland.

Acute Disease↗
PubMed1988

The pathogenesis of chronic recurrent parotitis in infants: a study of 93 cases including an analysis of the vascular and glandular changes before and after parasympathectomy.

Ninety-three cases of infantile chronic recurrent parotitis are recorded. Fifty-three cases were treated with parasympathectomy which was carried out at 2 levels. Good results were achieved in 79.1% of patients. The paper describes the use of the Doppler examination to study the effects of operation on the physiology of the parotid.

Child↗
PubMed1977

Experimental allergic sialoadenitis. X. Chronic destructive parotitis induced in immunized rats by daily intraductal challenges with antigen.

The right parotid duct of rats was instilled five to eight times with bovine serum albumin at daily intervals. Acute parotitis developed in non-sensitized animals, while chronic destructive sialoadenitis ensued in preimmunized rats. The morphological changes were reminiscent of those found in the salivary glands of patients with Sjögren's syndrome.

Acute Disease↗
PubMed1983

Immunological studies in two children with recurrent parotitis.

In two children with recurrent parotitis, labial salivary gland biopsies showed chronic sialoadenitis. Immunofluorescence studies disclosed deposits of immunoglobulins and complement in juxta-acinar small vessels. Case 1 had gluten enteropathy, IgA deficiency and high titres of antinuclear antibodies (ANA), and in vivo fixation of ANA to nuclei of different cells in lip, skin and jejunum was present. Case 2 showed deposition of IgM in the dermo-epidermal junction of the skin. These findings suggest that autoimmune reactivity and immune complexes may play a role in the pathogenesis of this disorder.

Adolescent↗
PubMed1997

Recurrent parotitis.

(1) Recurrent parotitis is probably caused by a congenital abnormality of the salivary gland ducts with recurrent attacks of ascending infection, perhaps aided by dehydration. The parotid gland is predominantly affected probably because of its lower rate of secretion compared with the submandibular gland. (2) The condition mainly affects children between the ages of 3 and 6, with males being more commonly affected. The symptoms peak in the first year of school, and usually, but not invariably, begin to subside at puberty. By the age of 22, most patients are completely symptom-free. When the disease starts after puberty, females are predominantly affected. (3) Ultrasound is the appropriate initial investigation, and is usually supplemented by sialography. The sialography may itself cause a resolution of symptoms. (4) Treatment is conservative in the first instance, and an expectant policy is indicated. More aggressive treatment is justified only for those adults with persistent problems. This may be parotid duct ligation, parotidectomy, or tympanic neurectomy, depending upon the preference and experience of the treating physician.

Child↗
PubMed1998

A case of Lyme disease with parotitis.

A-59-year-old Japanese woman presented a cellulitis-like erythematous skin rash, low-grade fever, and general fatigue, accompanied by a firm swelling of the right parotid gland. She had a history of tick bite on the right lateral neck 2 weeks before. Serum anti-Borrelia burgdorferi antibody was positive by Western blot analysis, and B. burgdorferi was isolated from the skin lesion. Serum amylase level was elevated with predominant salivary gland isozyme; the level returned to normal within 3 weeks following penicillin and tetracycline treatment. Parotitis might be included among the rare complications of Lyme disease affecting the head and neck region.

Borrelia burgdorferi Group↗
PubMedDate not supplied

A study on the pathogenesis of recurrent parotitis in childhood.

Roentgenologic, histopathologic, electron microscopic, virologic and immunologic studies were performed to investigate the etiologic features of recurrent parotitis in children. When examined sialographically and histopathologically, it was considered that pathologic changes in the parotid gland had developed as latent chronic inflammation with mild glandular destruction long before the disease became manifest clinically with acute exacerbation. Proliferation of the duct epithelium in the regenerative process and increase of intraductal pressure due to obstruction of the salivary outflow were assumed to be the causative factors of dilative changes of the peripheral ductal system. Investigation of complement fixation antibody, hemoagglutination inhibition antibody and neutralization antibody responses to mumps virus showed that onset of the disease was unrelated to mumps infection in the majority of cases. Increase of complement fixation antibody titer to various viruses was observed in many cases during acute exacerbation, and were considered to have brought about secondary ascending bacterial infection of the parotid gland by lowering of the systemic resistance. Comparison of serums IgA, IgG, IgM and salivary IgA in these patients with those of control children did not reveal participation of immunodeficiency in the development of this disease. But judging from the results of the long-term clinical follow-up study it was difficult to disregard the possibility that physiological immaturity of the immune response in young children may play some role in onset and recurrent exacerbation of the disease.

Antibodies, Viral↗
PubMedDate not supplied

Follow-up study of recurrent parotitis in children.

Recurrent parotitis in children is a well-described but rare condition of unknown cause. In this follow-up investigation the long-term course of the disease was studied both clinically and radiographically. In 23 of 25 patients investigated, the clinical symptoms disappeared before the patients were 22 years of age, independent of a given therapy. However, sialographic changes, mostly in the form of sialectasis, were seen on follow-up in the majority of cases, in spite of the fact that the patients were clinically symptom free.

Child↗
PubMed1980

Recurrent parotitis during childhood.

A case of a child suffering from recurrent parotitis secondary to inadvertant chewing on Stensen's duct orifice suggests that this cause may be common to other children plagued by this puzzling disorder.

Cheek↗
PubMed2003

Management of chronic parotitis: a review.

Chronic parotitis is an insidious inflammatory disorder, which is characterized by a recurrent, often painful, swelling of the gland or glands. Sialography remains the investigation of choice. Diagnostic siladenoscopy may complement or supersede sialography as the diagnostic procedure of choice, as more experience is gained in this technique and its use becomes more widespread. The management options are conservative or surgical, but controversy exists regarding the timing and method of surgical intervention. The surgical methods that have been described include injection of methyl violet - a sclerosing agent, ductal ligation, ductoplasty, tympanic neurectomy, and parotidectomy. Parotidectomy is considered the ultimate surgical option but because of its significant morbidity the exact technique and procedure that should be used remains contentious.

Anti-Inflammatory Agents↗
PubMed1987

Infantile recurrent sialectatic parotitis: the role of sonography and sialography in diagnosis and follow-up.

The results of a clinical, sonographic and sialographic study in 10 children (aged 4-10 years) with recurrent sialectatic parotitis are presented. Alteration in the sonographic pattern of the parotid glands, consisting of multiple hypoechogenic areas in the parenchyma, were found in four cases; milder nonhomogeneity was seen in four cases, and an almost normal pattern in two cases. Sonographic follow-up in two children showed a parallel reduction in non-homogeneity with symptomatic improvement. A probable therapeutic action following sialography using fat-soluble contrast medium was observed in four of the 10 children. The familial nature of the disease, which has not previously been described, is documented.

Child↗
PubMed2001

Chronic parotitis: diagnosis and treatment.

BACKGROUND: Chronic parotitis, or CP, is a nonspecific sialadenitis that often is seen first in the dental office. The cause, although not definitively determined, is most likely multifactorial and includes decreased salivation, stasis and an ascending retrograde duct infection. The authors present a case report to illustrate the symptomatology of CP to facilitate its differentiation from other entities that mimic CP. CASE DESCRIPTION: A 60-year-old woman with a 30-year history of recurrent swellings of her left parotid gland was diagnosed with CP. The diagnosis was based on history, clinical examination, salivary volume and chemistry, computerized tomographic scan and sialography. Treatment was palliative in nature. CLINICAL IMPLICATION: As a member of the health care team, the dentist must be familiar with the various causes of recurrent parotid infections. Early clinical recognition of CP leads to appropriate and successful care.

Chronic Disease↗
PubMed2004

Juvenile recurrent parotitis: a new method of diagnosis and treatment.

OBJECTIVE: Juvenile recurrent parotitis (JRP) is a nonobstructive, nonsuppurative parotid inflammation in young children. Causative factors, such as local autoimmune manifestation, allergy, infection, and genetic inheritance, have been suggested, but none of them has been proved to date. Until now, treatment of JRP was divided into conservative observation and antibiotic treatment, and no preventive therapy was available. METHODS: Twenty-six cases symptomatic JRP in children were diagnosed and treated with a combined endoscopic approach. Sialography and sialoendoscopy were performed bilaterally in all children. The treatment modality was composed of lavage, ductal dilation, and hydrocortisone injection. RESULTS: Sialography showed multiple sialectasis in the affected gland and in the contralateral one as well. Dilations and strictures were noticed in the main duct, and kinks could be identified in 31% of the glands. The main endoscopic finding was a white appearance of the ductal layer without the healthy blood vessel coverage. Recurrence of the symptoms occurred in only 2 (8%) children. CONCLUSIONS: The endoscopic technique provides the possibility of a correct diagnosis and treatment. In this article, we present a new treatment modality of irrigation and dilation under direct vision by endoscopically guided miniature surgical instruments.

Adolescent↗
PubMedDate not supplied

Long-term follow-up of the effect of tympanic neurectomy on sialadenosis and recurrent parotitis.

We examined the effect of tympanic neurectomy on the clinical symptoms and secretory function of the parotids in 13 patients with chronic parotitis or sialadenosis for 3 years. Each patient had significantly fewer complaints immediately after the surgery. In quite a few patients the improvement was transient only. Three years after neurectomy 3 of the 10 examined patients were free from complaints and 4 further patients had less severe complaints than before the surgery. Neurectomy was followed by a significant decrease in parotid flow rate and an increase in the sodium concentration of parotid saliva, while potassium concentration showed a slight decrease. Three years after the surgery the flow rate and the sodium concentration were moderately higher than before that. There was a significant, long-lasting change in the amylase activity of parotid saliva; 3 years after neurectomy it attained one-third of the preoperative value. A pharmacological test, carried out 3 years after neurectomy in 2 patients, suggested parasympathetic reinnervation of the parotid.

Atropine↗