EpistemisRecurrent parotid swelling
Specialty: Otolaryngology.
Why it occurs
- Chronic recurrent parotitis in children (of autoimmune or idiopathic etiology with sialectasias)
- Sjögren's syndrome with systemic autoimmune involvement and destruction of salivary acini
- Partid sialadenosis associated with metabolic disorders, chronic alcoholism or bulimia
- Intermittent sialolithiasis of the Sthenon's duct with partial obstruction
- Sarcoidosis with diffuse salivary gland involvement (Heerfordt syndrome)
Initial workup
High-resolution comparative glandular ultrasound with Doppler, blood analysis with determination of anti-Ro (SSA) and anti-La (SSB) antibodies, rheumatoid factor, antinuclear antibodies (ANA), CT of salivary glands with contrast, and biopsy of the labial minor salivary gland if Sjögren's Syndrome is suspected.
red flags
Ipsilateral facial palsy (asymmetry in the smile or inability to close the eye), persistent stony consistency of the gland on palpation, hard and painless satellite cervical lymphadenopathy, overlying ulceration of the parotid skin, or intense and constant pain that does not respond to common measures.
Standard management
- If the suspicion is autoimmune, the treatment is coordinated with rheumatology
- Pilocarpine — 5 mg orally every 8-12 hours to increase basal secretion
- Systemic corticosteroids in short, descending regimens during acute inflammatory outbreaks, such as prednisone
- Prophylaxis with natural citrus sialogogues (sour lemon candies) and regular descending parotid massages.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Otolaryngology
- Listed causes
- 5
- Treatment options
- 4