eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Salivary Glands

Parotitis: Follow-up

Author: Jerry W Templer, MD, Professor of Otolaryngology, University of Missouri Medical Center at Columbia
Coauthor(s): Benjamin Daniel Liess, MD, Assistant Professor, Department of Otolaryngology, University of Missouri-Columbia School of Medicine
Contributor Information and Disclosures

Updated: Jul 6, 2009

Follow-up

Further Inpatient Care

Hospitalization for parotitis is extremely unusual. Parotitis may arise in hospitalized patients who are severely ill, and it is treated as indicated above (see Treatment).

Inpatient & Outpatient Medications

Treatment of generic parotitis involves no specific medications. Discontinue medicines with atropinelike effects and substitute other medications when feasible.

Deterrence/Prevention

  • Generic deterrence is not available.
  • Adequate hydration, oral hygiene, and minimizing medications with atropine effects are helpful.
  • Immunization avoids epidemic parotitis (mumps).

Complications

  • Chronic parotitis destroys the glandular elements of the salivary glands and impairs the protective functions of saliva, leading to dental infections and caries.
  • Autoimmune parotitis is associated with an increased incidence of lymphoma.

Prognosis

The prognosis is good for all forms of parotitis. Associated or underlying diseases are the actual determinants of the prognosis.

Patient Education

Patients with chronic parotitis are instructed to maintain scrupulous dental care. Minor swelling and discomfort are managed with local heat and massage.

Miscellaneous

Medicolegal Pitfalls

Parotitis entails few medicolegal pitfalls. In most instances, a delay of diagnosis is not harmful to the patient. Keep the differential diagnosis (salivary gland neoplasms) in mind. Consider and diagnose diseases such as HIV when appropriate.

 


More on Parotitis

Overview: Parotitis
Differential Diagnoses & Workup: Parotitis
Treatment & Medication: Parotitis
Follow-up: Parotitis
Multimedia: Parotitis
References
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References

  1. Lilienthal HA. A method of incising parotid abscess without injury to the facial nerve distribution. Am J Surg. 1917;31(4):101-2.

  2. Hemenway WG, English GM. Surgical treatment of acute bacterial parotitis. Postgrad Med. Oct 1971;50(4):114-9. [Medline].

  3. Cope VZ. Acute necrotic parotitis. Br J Surg. 1919;7:130-3.

  4. Blair VP, Padgett EC. Pyogenic infection of the parotid glands and ducts. Arch Surg. 1923;7(1):1-36.

  5. Spiegel R, Miron D, Sakran W, Horovitz Y. Acute neonatal suppurative parotitis: case reports and review. Pediatr Infect Dis J. Jan 2004;23(1):76-8. [Medline].

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  7. Beitler JJ, Vikram B, Silver CE, et al. Low-dose radiotherapy for multicystic benign lymphoepithelial lesions of the parotid gland in HIV-positive patients: long-term results. Head Neck. Jan-Feb 1995;17(1):31-5. [Medline].

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  9. Shaffer AJ, Jacobsen AW. Mikulicz's syndrome, a report of ten cases. Amer J Dis Child. 1927;34:342-6.

  10. Sjogren H. Keratoconjunctivitis sicca. Acta Ophthalmologica. 1933;Supplement 2:1-145.

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  14. Ferraro FJ Jr, Rush BF Jr, Ruark D, Oleske J. Enucleation of parotid lymphoepithelial cyst in patients who are human immunodeficiency virus positive. Surg Gynecol Obstet. Nov 1993;177(5):524-6. [Medline].

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  16. Godwin JT. Benign lymphoepithelial lesion of the parotid gland adenolymphoma, chronic inflammation, lymphoepithelioma, lymphocytic tumor, Mikulicz disease. Cancer. Nov 1952;5(6):1089-103. [Medline].

  17. Mandel L, Witek EL. Chronic parotitis: diagnosis and treatment. J Am Dent Assoc. Dec 2001;132(12):1707-11; quiz 1727. [Medline].

  18. Morgan WS, Castleman B. A clinicopathologic study of Mikulicz's disease. Am J Pathol. May-Jun 1953;29(3):471-503. [Medline].

  19. Shaha AR, DiMaio T, Webber C, Thelmo W, Jaffe BM. Benign lymphoepithelial lesions of the parotid. Am J Surg. Oct 1993;166(4):403-6. [Medline].

  20. Wang S, Li J, Zhu X, et al. Gland atrophy following retrograde injection of methyl violet as a treatment in chronic obstructive parotitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Mar 1998;85(3):276-81. [Medline].

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Further Reading

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Keywords

parotitis, sialadenitis, acute bacterial parotitis, chronic bacterial parotitis, chronic recurrent parotitis, infectious parotitis, acute parotitis in neonates, acute viral parotitis, mumps, HIV parotitis, HIV parotitis in children, acute surgical parotitis, lymphoepithelial lesion, chronic punctate parotitis, autoimmune parotitis, Mikulicz disease, Sjögren disease, lymphoepithelial lesion of Godwin, recurrent parotitis of childhood, EBV infection, Epstein-Barr virus infection, parotitis in tuberculosis, sarcoidosis

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Contributor Information and Disclosures

Author

Jerry W Templer, MD, Professor of Otolaryngology, University of Missouri Medical Center at Columbia
Jerry W Templer, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, Missouri State Medical Association, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Benjamin Daniel Liess, MD, Assistant Professor, Department of Otolaryngology, University of Missouri-Columbia School of Medicine
Benjamin Daniel Liess, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Laryngological Rhinological and Otological Society, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Ted L Tewfik, MD, FRCS(C), Professor, Department of Otolaryngology, Director of Continuing Medical Education of Otolaryngology, McGill University Medical School; Director, Director of Professional Affairs of Otolaryngology, Department of Otolaryngology, Montreal Children's Hospital; Senior Staff, Montreal General Hospital and Royal Victoria Hospital
Ted L Tewfik, MD, FRCS(C) is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Society of Pediatric Otolaryngology, Canadian Medical Association, Canadian Society of Otolaryngology-Head & Neck Surgery, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Dominique Dorion, MD, MSc, FRCSC, Program Director and Division Chair, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke, Canada
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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