Diagnosis

The diagnosis of an acute inflammation of the parotid gland is usually divided into several steps. Usually, a detailed doctor-patient consultation (anamnesis) is conducted at the beginning. During this conversation, the symptoms and the causal relationship between the symptoms should be described in as much detail as possible.

Both the quality and the exact localization of the complaints perceived by the patient can provide a decisive indication of the underlying clinical picture. The suspicion of the presence of an acute inflammation of the parotid gland usually results from the information about the time when the symptoms first occurred and the factors that cause them to increase in intensity. Typical for the acute inflammation of the parotid gland is pain during chewing.

After the doctor-patient consultation, a physical examination is typically followed by a detailed inspection of the affected area of the body (in this case the oral cavity and cheeks). In case of an acute inflammation of the parotid gland, hardening, swelling, redness and overheating of the cheeks can typically be detected. In many cases, external pressure causes purulent secretion to escape from the excretory duct of the parotid gland.

Ideally, this secretion should be collected and analyzed in the laboratory. In this way, the underlying pathogen can be detected and targeted treatment initiated. In addition, the oral cavity should be inspected closely during the clinical examination and the status of the teeth should also be determined.

This is typically followed by a blood test. With the help of possible changes in the blood count (increase of inflammation factors; especially leukocytes and C-reactive protein) the presence of inflammatory processes can be proven. In this context, however, it should be noted that an increase in inflammatory parameters does not necessarily prove the presence of parotid gland inflammation.

The increase in white blood cells (leukocytes) and C-reactive protein (CRP) may also indicate an inflammation located elsewhere. In the diagnosis of acute inflammation of the parotid gland, the search for the cause also plays an important role. If it is suspected that a salivary stone could be responsible for the occurrence of the inflammatory processes, an ultrasound examination (sonography) should be performed urgently.

With the help of this examination method, the treating physician is usually able to detect salivary stones from a size of about one and a half millimeters. In addition, the ultrasound examination can, under certain circumstances, serve to detect abscesses or tumors. If the findings are unclear and/or the symptoms are particularly pronounced, further imaging procedures may also be necessary.

In the diagnosis of acute parotid gland inflammation, magnetic resonance imaging (MRI) and computed tomography (CT) play an important role.In addition, in many cases an endoscopy of the parotid gland duct and a so-called “fine needle puncture” are indicated to collect samples. Sialography is an important diagnostic tool for acute inflammation of the parotid gland caused by salivary stones. In this examination method, both the glandular duct system and the gland itself are depicted.

With the help of a contrast medium, which is administered to the patient via the vein, constrictions and/or blockages within the glandular duct system can be radiographically depicted. In case of acute inflammation of the parotid gland, the choice of the appropriate treatment method depends on various factors. Firstly, the fact whether the inflammatory processes were caused by a salivary stone plays an important role.

On the other hand, the choice of the best treatment method also depends on the severity of the clinical picture. In general, in the presence of an acute inflammation of the parotid gland, the use of so-called “saliva looseners” to stimulate saliva production is recommended. Especially the use of sweets, chewing gum and beverages has been proven in clinical routine so far.

The salivary gland and its excretory ducts can be cleansed by a targeted increase in saliva production and increased secretion of thin secretions. In many cases, the increased salivary flow can even be used to flush out small tilted salivary stones from the excretory duct. Since in most cases, bacterial involvement in the development of acute inflammation of the parotid gland is directly or at least indirectly detectable, the administration of antibiotics is an important part of the treatment of affected patients.

However, it should be noted that viral acute inflammation of the parotid gland does not respond to antibiotic treatment and can usually only be treated symptomatically. For the patients concerned, the most important treatment step is to relieve the pain by taking analgesic medication (analgesics). In particular, drugs containing the active ingredients ibuprofen or paracetamol have proven to be effective in the treatment of acute inflammation of the parotid gland.

If an abscess develops during the course of the inflammatory process, in most cases a surgical opening of the abscess cavity must be performed. The complete removal of the parotid gland is always necessary if inflammatory processes occur more frequently or a malignant tissue change (tumor) is suspected. Salivary stones that cannot be flushed out by increasing secretion must be removed by other means.

In the case of salivary stones that are located at the end of the excretory duct, the treatment can be carried out with the help of a duct slit and regular massages of the parotid gland, regardless of the size of the stone. Salivary stones that are not palpable from the outside and lie deep in the duct system can be treated with the help of so-called “extracorporeal shock wave lithotripsy” (ESWL for short). In this method, the salivary stone is displaced by sound waves from outside.

Large stones, on the other hand, usually have to be removed surgically. If an uncomplicated inflammation of the parotid gland is present, treatment with homeopathic remedies is possible. However, a doctor must ensure that there is no fever, rotten tooth or obstruction of the saliva flow from the gland.

Only then can a safe treatment with homeopathic remedies be started. Globules or drops of Ailanthus glandulosa (Tree of Gods) have proven to be effective and, together with Schuessler salts such as potassium chloratum, can support healing. Belladonna globules (deadly nightshade) are also attributed a healing effect.

In addition, drinking sage tea can stimulate the salivary flow and thus “flush” the pathogens out of the inflamed parotid gland. Sage also has an anti-inflammatory effect. Basically, a homeopathic treatment should optimally balance the mineral balance of the affected person and stimulate the salivary flow sufficiently so that the pathogens can be eliminated from the gland.