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Symptoms, diagnosis and causes of parotitis (chronic)

Symptoms, diagnosis and causes of parotitis (chronic)

Symptoms, diagnosis and causes of parotitis (chronic)

Symptoms, diagnosis and causes of parotitis (chronic)

These conditions form part of the spectrum of chronic inflammatory conditions of unknown origin. All share a common precursor event that is reduced salivary secretion rate and subsequent stagnation of salivary flow. These conditions are all more common in the parotid gland because of thicker saliva, which is more susceptible to bacterial infection than submandibular saliva.

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Incidence/Age

Chronic recurrent parotitis in infants up to 12 years is more common in males than females. Chronic sialoadenitis occurs in adults and more frequently in females than males. Benign lymphoepithelial lesion is more common in adult females.

Anatomy & Physiology

The parotid gland consists of a superficial (outer) and a deep (inner) part, which are separated by the tree-like terminal branches of the facial nerve, responsible for facial movement. Lymph nodes are present within the gland.

Saliva leaves the gland through Stensen's duct, which pierces the facial muscles and enters the mouth through the cheek opposite the second upper molar tooth. Saliva flow is stimulated by chewing and the presence of food in the mouth, particularly sour substances. The stimulus is mediated via parasympathetic nerve fibres carried on the auriculotemporal nerve to the parotid gland.

The submandibular gland consists of superficial and deep parts separated by the myelohyoid muscle. The duct leaves the deep part of the gland and enters the floor of the mouth and meets its opposite partner. The deep part of the gland is intimately related to the hypoglossal nerve, which moves the tongue, and the lingual nerve, which provides sensation to the front half of the tongue.

Saliva flow is stimulated via parasympathetic (chorda tympani) nerve fibres carried along the lingual nerve.

Causes

The causes are unknown, but both chronic recurrent parotitis and acute suppurative sialoadenitis can progress onto chronic sialoadenitis. Chronic recurrent parotitis may also progress into a benign benign lymphoepithelial lesion or may resolve spontaneously at puberty.

Symptoms/Signs

Initially mild recurrent painful swelling of the glands, often aggravated by eating. It initially lasts for some hours and eventually becomes a more permanent swelling. In advanced cases, a dry mouth may be a problem in up to 80% of adult patients, but almost never in children.

Complications of Disorder

Benign lymphoepithelial lesions may rarely go on to develop lymphomas or carcinomas.

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Get a quote for parotitis (chronic) treatment >

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