Diseases of the parotid gland

Diseases of the parotid gland are not uncommon, even if only a few people are affected. Many of them can also be quite unpleasant or even very disturbing. For example, inflammations of the parotid gland and salivary stones in particular can cause severe pain (see: Salivary stone ear).

Depending on the severity of the underlying disease, these can also be accompanied by swelling of the upper neck area and reddening of the skin surrounding the parotid gland. If the inflammation is correspondingly severe, general symptoms such as fever and fatigue can also occur. Since inflammation of the salivary gland can become chronic, if it occurs more frequently, treatment of the disease is definitely advisable.

This is usually done with antibiotics. To relieve the pain, painkillers such as ibuprofen, paracetamol or, in the case of severe pain, metamizole (Novalgin novamine sulfone) are typically prescribed. These have not only analgesic (analgesic) but also anti-inflammatory (antiphlogistic) effects, which also help to treat the inflammation.

You can find more information here: Pain in the parotid glandWhen an inflammation of the salivary gland occurs, there is often a salivary stone behind it, which blocks the salivary gland’s excretory duct. As a result, bacteria, such as Staphylococcus aureus, can multiply largely unhindered in the salivary gland, resulting in the typical symptoms of an inflammation of the salivary gland with pain and swelling of the gland. The reason for salivary stone formation (sialolithiasis) is still largely unexplained.In any case, metabolic disorders and disorders of saliva production (dyschyria), which lead to a high calcium content, have a beneficial effect.

This significantly promotes the formation of salivary stones, which typically consist of calcium phosphate – a salt that is also often present in urinary stones. A blockage of the salivary duct of the parotid gland caused by small salivary stones can in some cases be solved by sucking sugar-free sweets or chewing gum in combination with a massage of the parotid gland. This is called “loosening of saliva“.

When the parotid gland hurts, this is usually caused by inflammation of the salivary gland (parotitis). The inflammation can even lead to a swelling of the throat area, which can become noticeable by a reddening of the skin covering the gland. General symptoms of an infection such as fatigue and fever can also occur with the appropriate degree of inflammation.

Inflammation of the parotid gland is usually the result of another disease of the salivary gland, such as salivary stones or disturbed saliva production. This can then lead to colonization of the salivary gland by bacteria, such as Staphylococcus aureus, and cause bacterial inflammation. Viral inflammation of the parotid gland, e.g. by the well-known mumps virus, has become rare thanks to the availability of vaccines worldwide.

However, salivary stones can cause pain even without a subsequent inflammation. Since failure to treat inflammation can lead to a chronicity of the disease, adequate therapy is of great importance. In the case of viral infections, anti-inflammatory drugs and painkillers play a major role.

If the infection is caused by bacteria, antibiotics should also be prescribed. Adequate oral hygiene also contributes to a quick recovery. This also includes the so-called “loosening of saliva”.

Simply sucking (sugar-free) sweets or chewing gum promotes saliva production and thus the flushing out of pathogens. Cancer of the parotid gland is also often referred to as parotid carcinoma. Parotid gland cancer is a rare form of cancer, which usually grows very slowly and causes no pain at first.

The causes of parotid gland cancer are considered to be chronic inflammation in the area of the salivary glands, but bacterial infestation can also lead to parotid gland cancer in rare cases and under certain circumstances. In addition, salivary stones and chronic alcohol and nicotine consumption are also considered to promote the growth of the tumor. The first signs of parotid gland cancer can already be swelling or pain.

You can find more information on this under Swelling of the parotid gland and Pain in the parotid gland. In an advanced stage, facial paralysis may also occur. This also includes impairments of the eyes.

If parotid gland cancer is suspected, your family doctor will usually refer you to an ear, nose and throat doctor, who will then take a closer look at the situation by simply palpating the area. Furthermore, biopsies of the tissue can be performed to determine whether the tumor is benign or malignant. Finally, using imaging techniques in the form of ultrasound, CT and MRI, the location, size and type of tumor can be determined.

Parotid gland cancer must and should always be surgically removed. Even if it is a benign tumor, there is a very high probability that it will turn into a malignant tumor over time, which will cause metastases. In an operation, the entire parotid gland is removed, which is often complicated and problematic because a facial nerve (nervus facialis), which controls facial expression, runs directly through the parotid gland.

This can result in possible facial paralysis. However, the probability of this is very low and is less than 1%. A lump in the parotid gland can usually be felt or recognized by a layperson.

A lump in the parotid gland can have various causes.

A tumor can be the cause for the knot formation. This can be a benign or a malignant tumor.These two types cannot be distinguished by simple palpation, which is why in all cases an ENT specialist should be consulted to examine the whole thing more closely.
Through various examinations, a tumor can then finally be diagnosed as benign or malignant. You can find all further information in our article Parotid gland cancer.
Behind a swelling of the parotid gland an abscess, i.e. a large accumulation of pus, can also be hidden. These can easily be caused by ascending inflammation from the mouth area.
Possible stone formation in a glandular duct can also be the cause of the clinical picture, so that the flow of saliva is hindered.
As a result, the parotid gland swells and pain occurs. The pain is usually caused by increased tissue pressure within the parotid gland. In extreme cases, this can even lead to an impairment of the facial nerve running through the parotid gland and thus to paralysis of the facial muscles.

This should also be clarified by an ENT specialist in any case.

If stones develop in a salivary gland or its excretory duct, this is called sialolithiasis. As a rule, it does not affect the parotid gland, but the parotid gland of the lower jaw. In only one fifth of cases, salivary stones develop in the parotid gland.

Salivary stones occur relatively frequently with about 30 to 50 cases per million inhabitants. Men and women are affected equally often. The cause for the development of salivary stones is usually a disturbed salivary secretion (dyschyria) or a change in the composition of the saliva.

The stones themselves usually consist of a substance that not only occurs in urinary stones, but is also a major component of our bones. Symptoms of sialolithiasis occur particularly during eating, i.e. at times of greatest saliva production. In this case, pain and a swelling of the respective gland in the case of the parotid gland is the most common.

A treatment of salivary stone formation or parotid stone formation is carried out depending on the size of the stones. Small stones can possibly be flushed out by the so-called “saliva loosening”. This is simply the promotion of saliva production by sucking or chewing sweets or chewing gum.

A massage of the parotid gland can provide additional relief here under certain circumstances. Larger stones, however, can be removed surgically. An alternative is ultrasound therapy, in which the salivary stones are broken up and then washed out of the saliva.

Another alternative treatment is sialendoscopy, in which small stones in the salivary duct can be removed visually with small pliers or a basket, and constrictions in the duct can be widened. Swelling of the parotid gland can be the result of various diseases. These include, above all, inflammation of the parotid gland, but also the formation of parotid stones and various benign and malignant tumor diseases.

Especially in the case of parotid gland inflammation, other symptoms such as pain, especially when pressure is applied to the swelling, a reddening of the surrounding skin and general symptoms such as fever and fatigue. The inflammation of the parotid gland (parotitis) can be either viral or bacterial, although viral parotides (mainly caused by mumps) have become rare nowadays. Bacterial inflammation, on the other hand, is comparatively common and is usually based on a pre-existing underlying disease such as salivary stones, which obstruct the flow of saliva and thus create a good environment for bacteria to multiply.

However, salivary stones themselves can also lead to swelling of the parotid gland even without an accompanying inflammation. This is probably caused by as yet unexplained metabolic disorders. However, the formation of salivary stones (sialolithiasis) occurs much more frequently in the lower parotid gland (Glandula submandibularis), as its saliva has a significantly higher calcium content.

In addition to salivary stones and inflammation of the salivary glands, tumor diseases can also cause swelling of the glandula parotis. These can be either benign or malignant.Benign tumors usually have a very good prognosis, but should be surgically removed, as there is still a low probability of degeneration. Especially men are affected by benign tumors of the salivary glands.

Malignant salivary gland tumors are less common. They are usually treated by a surgical procedure in which half or even the entire salivary gland is removed. In some cases, however, the tumor can also be irradiated. You can find detailed information on this topic at Swelling of the parotid gland