Pneumoparotitis

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Pneumoparotitis (also termed pneumosialadenitis [1] wind parotitis, [1] surgical mumps, [2] or anaesthesia mumps), [2] is a rare cause of parotid gland swelling which occurs when air is forced through the parotid (Stensen) duct resulting in inflation of the duct. [3]

Contents

Signs and symptoms

The size of the swelling is variable, but it is soft [4] and can occur on one side or both sides. [1] It is typically non tender, [4] although sometimes there may be pain. [1] It usually resolves over minutes to hours, however occasionally this may take days. [1] The condition can be transient or recurrent. [5]

Causes

The condition is caused by raised air pressure in the mouth. [1]

Diagnosis and management

Pneumoparotitis is often misdiagnosed and incorrectly managed. [5] The diagnosis is based mainly on the history. [1] Crepitus may be elicited on palpation of the parotid swelling, [1] and massaging the gland may give rise to frothy saliva or air bubbles from the parotid papilla. [1] Further investigations are not typically required, however sialography, ultrasound and computed tomography may all show air in the parotid gland and duct. [1]

Management is simply by avoidance of the activity causing raised intraoral pressure which is triggering this rare condition. [1]

Prognosis

Recurrent pneumoparotitis may predispose to sialectasis, recurrent parotitis, and subcutaneous emphysema [5] of the face and neck, and mediastinum, and potentially pneumothorax. [1]

Epidemiology

The condition is rare. [5] It is more likely to occur in persons who regularly have raised pressure in the mouth, for example wind instrument players, [6] and balloon [1] and glass-blowers. [7] Cases have also been reported with bicycle tyre inflation, [1] whistling, [1] nose blowing, [1] cough [1] and valsalva manoeuvre to clear the ears. [1] It can be an iatrogenic effect of dental treatment, [1] spirometry, [1] and positive pressure ventilation. [2] Apart from these factors, the condition mainly occurs in adolescents, often self-inflicted due to psychological issues. [7] [8]

Related Research Articles

<span class="mw-page-title-main">Mumps</span> Human disease caused by paramyxovirus

Mumps is a viral disease caused by the mumps virus. Initial symptoms are non-specific and include fever, headache, malaise, muscle pain, and loss of appetite. These symptoms are usually followed by painful swelling of the parotid glands, called parotitis, which is the most common symptom of infection. Symptoms typically occur 16 to 18 days after exposure to the virus and resolve within two weeks. About one third of infections are asymptomatic.

<span class="mw-page-title-main">Salivary gland</span> Exocrine glands that produce saliva through a system of ducts

The salivary glands in mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands, as well as hundreds of minor salivary glands. Salivary glands can be classified as serous, mucous, or seromucous (mixed).

<span class="mw-page-title-main">Great auricular nerve</span> Cutaneous nerve of the head

The great auricular nerve is a cutaneous nerve of the head. It originates from the cervical plexus, with branches of spinal nerves C2 and C3. It provides sensory innervation to the skin over the parotid gland and the mastoid process of the temporal bone, and surfaces of the outer ear.

<span class="mw-page-title-main">Parotid gland</span> Major salivary gland in many animals

The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion of starches. There are also two other types of salivary glands; they are submandibular and sublingual glands. Sometimes accessory parotid glands are found close to the main parotid glands.

<span class="mw-page-title-main">Parotitis</span> Medical condition

Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation.

<span class="mw-page-title-main">Ear pain</span> Pain in the ear

Ear pain, also known as earache or otalgia, is pain in the ear. Primary ear pain is pain that originates from the ear. Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt.

<span class="mw-page-title-main">Auriculotemporal nerve</span> Branch of the mandibular nerve

The auriculotemporal nerve is a branch of the mandibular nerve (CN V3) that runs with the superficial temporal artery and vein, and provides sensory innervation to various regions on the side of the head.

<span class="mw-page-title-main">Parotid duct</span>

The parotid duct, or Stensen duct, is a salivary duct. It is the route that saliva takes from the major salivary gland, the parotid gland, into the mouth. It opens into the mouth opposite the second upper molar tooth.

<span class="mw-page-title-main">Pleomorphic adenoma</span> Medical condition

Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of epithelial (ductal) cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. It derives its name from the architectural Pleomorphism seen by light microscopy. It is also known as "Mixed tumor, salivary gland type", which refers to its dual origin from epithelial and myoepithelial elements as opposed to its pleomorphic appearance.

<span class="mw-page-title-main">Sialadenitis</span> Medical condition

Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands.

<span class="mw-page-title-main">Sialolithiasis</span> Medical condition

Sialolithiasis is a crystallopathy where a calcified mass or sialolith forms within a salivary gland, usually in the duct of the submandibular gland. Less commonly the parotid gland or rarely the sublingual gland or a minor salivary gland may develop salivary stones.

Uveoparotitis is a symptom of sarcoidosis. It describes a chronic inflammation of the parotid gland (parotitis) and part of the eye called the uvea (uveitis). There is also a phenomenon called Waldenström's uveoparotitis, where the symptom is related to Heerfordt's syndrome. The condition was first described in 1909.

<span class="mw-page-title-main">Salivary gland tumour</span> Medical condition

Salivary gland tumours, also known as mucous gland adenomas or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800 to 1000 small mucus-secreting glands located throughout the lining of the oral cavity. Patients with these types of tumours may be asymptomatic.

Heerfordt syndrome is a rare manifestation of sarcoidosis. The symptoms include inflammation of the eye (uveitis), swelling of the parotid gland, chronic fever, and in some cases, palsy of the facial nerves.

<span class="mw-page-title-main">Otitis externa</span> Inflammation of the ear canal

Otitis externa, also called swimmer's ear, is inflammation of the ear canal. It often presents with ear pain, swelling of the ear canal, and occasionally decreased hearing. Typically there is pain with movement of the outer ear. A high fever is typically not present except in severe cases.

<span class="mw-page-title-main">Salivary gland disease</span> Medical condition

Salivary gland diseases (SGDs) are multiple and varied in cause. There are three paired major salivary glands in humans – the parotid glands, the submandibular glands, and the sublingual glands. In addition there are about 800-1000 minor salivary glands in the mucosa of the mouth. The parotid gland is located in front of each ear, and secretes mostly serous saliva via the parotid duct into the mouth, usually opening roughly opposite the maxillary second molar. The submandibular gland is located medial to the angle of the mandible, and it drains its mixture of serous and mucous saliva via the submandibular duct into the mouth, usually opening in a punctum located in the floor of mouth. The sublingual gland is located below the tongue, on the floor of the mouth. It drains its mostly mucous saliva into the mouth via about 8-20 ducts which open along the plica sublingualis.

A sialocele is a localized, subcutaneous cavity containing saliva. It is caused by trauma or infection. They most commonly develop about 8–14 days after injury.

<span class="mw-page-title-main">Parotidectomy</span> Surgical removal of the parotid gland

A parotidectomy is the surgical excision (removal) of the parotid gland, the major and largest of the salivary glands. The procedure is most typically performed due to neoplasms (tumors), which are growths of rapidly and abnormally dividing cells. Neoplasms can be benign (non-cancerous) or malignant (cancerous). The majority of parotid gland tumors are benign, however 20% of parotid tumors are found to be malignant. Parotidectomy is performed mostly by oral and maxillofacial surgeon and ENT surgeon.

<span class="mw-page-title-main">Pneumatosis</span> Abnormal presence of air or other gas within tissues

Pneumatosis is the abnormal presence of air or other gas within tissues.

A cervical thymic cyst, also called thymopharyngeal duct cyst, is a fluid-filled mass that occurs when the thymopharyngeal duct, an embryonic structure connecting the nascent thymus with the embryonic pharynx, fails to close and disappear. A thymic cyst is typically a solitary mass on one side of the neck, and is usually found near the carotid sheath. Some cervical thymic cysts may extend into the mediastinum. It is usually asymptomatic. The diagnostic process includes differentiating between other causes of neck masses in infants and children, including branchial cleft cysts and cystic hygromas. The treatment is surgical excision. On histologic examination, the wall of the cyst includes thymic tissue, and may include parathyroid gland tissue because of the parathyroid gland's common embryonic origin with the thymus gland in the third pharyngeal pouch. Fewer than 100 cases of cervical thymic cysts have been reported in the medical literature.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Joiner MC; van der Kogel A (15 June 2016). Basic Clinical Radiobiology, Fifth Edition. CRC Press. p. 1908. ISBN   978-0-340-80893-1.
  2. 1 2 3 Gibson AM; Benko KR (5 May 2013). Head, Eyes, Ears, Nose, and Throat Emergencies, An Issue of Emergency Medicine Clinics. Elsevier Health Sciences. p. 124. ISBN   978-1-4557-7171-4.
  3. ↑ McCormick, Michael E.; Bawa, Gurneet; Shah, Rahul K. (2013). "Idiopathic recurrent pneumoparotitis". American Journal of Otolaryngology. 34 (2): 180–182. doi:10.1016/j.amjoto.2012.11.005. ISSN   0196-0709. PMID   23318047.
  4. 1 2 Mukherji SK; Chong V (1 January 2011). Atlas of Head and Neck Imaging: The Extracranial Head and Neck. Thieme. p. 147. ISBN   978-1-60406-525-1.
  5. 1 2 3 4 Goguen, LA; April, MM; Karmody, CS; Carter, BL (December 1995). "Self-induced pneumoparotitis". Archives of Otolaryngology–Head & Neck Surgery. 121 (12): 1426–9. doi:10.1001/archotol.1995.01890120082017. PMID   7488376.
  6. ↑ Kreuter, M; Kreuter, C; Herth, F (February 2008). "[Pneumological aspects of wind instrument performance--physiological, pathophysiological and therapeutic considerations]". Pneumologie (Stuttgart, Germany). 62 (2): 83–7. doi:10.1055/s-2007-996164. PMID   18075966.
  7. 1 2 Ferlito, A; Andretta, M; Baldan, M; Candiani, F (June 1992). "Non-occupational recurrent bilateral pneumoparotitis in an adolescent". The Journal of Laryngology and Otology. 106 (6): 558–60. doi:10.1017/s0022215100120146. PMID   1624898.
  8. ↑ Markowitz-Spence, L; Brodsky, L; Seidell, G; Stanievich, JF (December 1987). "Self-induced pneumoparotitis in an adolescent. Report of a case and review of the literature". International Journal of Pediatric Otorhinolaryngology. 14 (2–3): 113–21. doi:10.1016/0165-5876(87)90021-8. PMID   3325441.
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