| What Is It?
Parotitis is an inflammation of the parotid
glands, which are large salivary glands located in front of each ear.
Either one or both parotid glands can be inflamed. There are many causes
of the inflammation, including:
- Bacterial infection — A bacterial infection
is more common in older people, who often take medications that cause
dry mouth (xerostomia), or are dehydrated or debilitated by chronic
(long-lasting) disease. When saliva flow is reduced, bacteria can collect
and grow in the duct that moves saliva from the parotid gland to the
mouth. This causes an infection.
- A salivary stone in the parotid glands — The
stone blocks the flow of saliva and can lead to infection.
- Mucus plugs — Mucus plugs in the salivary
duct can block or slow the flow of saliva and cause parotitis.
- Sjögren's syndrome — This chronic, autoimmune
salivary disease is a long-term inflammatory condition of the salivary
glands. The cause is unknown.
- Viral infections — Mumps used to be the
most common viral infection of the parotid glands. However, it is rare
today because of vaccinations.
- AIDS — About 5% of people with AIDS have
significantly inflammed and enlarged parotid glands.
- A tumor — Occasionally, a tumor can block
the flow of saliva and lead to parotitis. In most cases, these tumors
are benign (not cancerous).
- Certain medical conditions — Some conditions
such as diabetes, alcoholism and bulimia also can cause the parotid
glands to enlarge. Usually, they do not cause pain or infection.
Symptoms
The symptoms depend on the cause of the parotitis. Symptoms can include
swelling and pain.
Diagnosis
If the gland is tender and sore and the skin over it is inflamed, the
gland probably is infected. Your doctor may remove fluid from the gland
and have it tested to determine the type of infection you have.
Your doctor can diagnose mumps based on your symptoms and the information
you give your doctor about your medical history.
Your doctor may take an X-ray if
he or she suspects you have a salivary stone. In some cases, a computed
tomography (CT) scan calso may help to diagnose parotitis.
Expected Duration
Bacterial parotitis usually responds to antibiotics within days.
Mumps disappears on its own in about 10 days.
Parotitis related to AIDS or Sjögren's syndrome can be managed,
but it may never disappear completely. Parotitis related to other conditions
(such as alcoholism or bulimia) should subside if the condition is brought
under control.
Parotitis resulting from a salivary stone or tumor should subside after
the obstruction is removed.
Prevention
People who experience recurrent parotitis are often more prone to form
salivary stones or mucus plugs. Drinking a lot of fluids and stimulating
saliva flow — for example, with sugarless candy — can help
to prevent stones and plugs. Your dentist also can show you how to manipulate
your parotid glands to keep saliva flowing.
Treatment
If you have a bacterial infection, you will be given antibiotics. If
you are diagnosed with mumps, treatment is not necessary. The condition
will go away on its own.
Small salivary stones can be removed with a probe. Larger stones may
require surgery. Some stones can be flushed out or removed with tweezers.
People with many salivary stones may need to have a parotid gland surgically
removed to solve the problem.
Mucus plugs can be washed away if salivary flow is increased by drinking
more fluids and sucking on sugarless candy.
For people with Sjögren's syndrome, drugs such as pilocarpine (Salagen)
are available. This medication increases salivary flow. Anti-inflammatory
medications also may help.
In people with AIDS-related parotitis, anti-AIDS medications may help
the parotitis.
When To Call a Professional
Call your physician or dentist if you have enlarged or painful glands,
particularly if these symptoms are persistent.
Prognosis
The long-term outlook for bacterial infections, mucus plugs and stones
is generally good. Chronic causes such as Sjögren's syndrome usually
are managed and watched. However, some forms of parotitis are persistent,
or continue to return.
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