Parotitis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

Surgery is recommended for parotitis caused by salivary duct stones, abscess from bacterial infection, parotid gland neoplasia, and recurrent parotitis of unknown etiology of which non-surgical therapies fail to resolve the disease. Sialendoscopy is preferred to relieve salivary duct stone-based parotitis due to the minimally-invasive nature of the procedure. Abscess drainage is performed by superficial incision. Partial or total parotidectomy is performed to remove neoplasia and when recurrent parotitis does not respond to non-surgical therapy. It is not recommended unless necessary due to the likelihood of complications.

Surgery

Sialendoscopy

Sialendoscopy is used to relieve parotitis caused by salivary duct stone obstruction.
It is a minimally-invasive surgical procedure to remove salivary gland stones using graspers, miniforceps, Dormia baskets and balloons.^[1]
- Stones with diameter <3mm: stone is removed directly.^[2]
- Stones with diameter >3mm: stone is fragmented beforehand using concentrated lasers.

Abscess drainage

Parotitis caused by an abscess from bacterial infection can be relieved by incision and drainage.

Parotidectomy

Partial or total surgical removal of the parotid gland is used for parotitis caused by a maligant or benign neoplasm, as well as recurrent parotitis of unknown etiology.^[3]

Surgical intervention is usually only recommended when other therapies are insufficient due to the difficulty of the procedure and likelihood of the following complications:^[4]
- Facial paralysis from interference in the vasa nervorum
- Frey’s syndrome
- Difficulty opening mouth
- Hypoesthesia of greater auricular nerve

References

↑ Al-Abri R, Marchal F (2010). “New era of Endoscopic Approach for Sialolithiasis: Sialendoscopy”. Sultan Qaboos Univ Med J. 10 (3): 382–7. PMC 3074741. PMID 21509260.
↑ Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). “Modern management of obstructive salivary diseases”. Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.
↑ Sadeghi N, Black MJ, Frenkiel S (1996). “Parotidectomy for the treatment of chronic recurrent parotitis”. J Otolaryngol. 25 (5): 305–7. PMID 8902688.
↑ Marchese-Ragona R, De Filippis C, Marioni G, Staffieri A (2005). “Treatment of complications of parotid gland surgery”. Acta Otorhinolaryngol Ital. 25 (3): 174–8. PMC 2639867. PMID 16450773.

Template:WikiDoc Sources

[pmid21509260-1] Al-Abri R, Marchal F (2010). “New era of Endoscopic Approach for Sialolithiasis: Sialendoscopy”. Sultan Qaboos Univ Med J. 10 (3): 382–7. PMC 3074741. PMID 21509260.

[pmid17957846-2] Capaccio P, Torretta S, Ottavian F, Sambataro G, Pignataro L (2007). “Modern management of obstructive salivary diseases”. Acta Otorhinolaryngol Ital. 27 (4): 161–72. PMC 2640028. PMID 17957846.

[pmid8902688-3] Sadeghi N, Black MJ, Frenkiel S (1996). “Parotidectomy for the treatment of chronic recurrent parotitis”. J Otolaryngol. 25 (5): 305–7. PMID 8902688.

[pmid16450773-4] Marchese-Ragona R, De Filippis C, Marioni G, Staffieri A (2005). “Treatment of complications of parotid gland surgery”. Acta Otorhinolaryngol Ital. 25 (3): 174–8. PMC 2639867. PMID 16450773.

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