The parotid gland is very susceptible to various forms of disease due to the free access via the ear. Due to the connection to the oral cavity, this is usually also affected by inflammation. The causes of parotid gland inflammation are equally diverse and should always be evaluated by a specialist.
What is parotid gland inflammation?
A disease of the parotid gland, called parotis, is usually an inflammation. Due to salivary stones (sialolith), there may be a reduction in salivary outflow. Here, too, the inflammation is likely to spread. Particularly unpleasant for those affected is the pain that develops when the parotid gland swells. Due to the tight covering with a layer of connective tissue, nerve tracts are often squeezed. This can result in various functional disorders and severe pain.
Causes
Several possible causes can be considered for parotid gland disease: bacterial and viral infections, autoimmunologic diseases, salivary stones, swelling of the salivary gland, benign as well as malignant tumors. One type of disease is the so-called mumps. It is caused by the mumps virus. This is a very painful inflammation. A bacterial infection often occurs in conjunction with other diseases of the parotid gland, such as salivary stones. The blocked outflow of saliva leads to a buildup of bacteria, which in turn leads to an inflammation of the parotid gland. In most cases, these bacteria are staphylococci or streptococci. A bacterial infection can quickly develop into a chronic inflammation. Therefore, prompt and consistent treatment is advised. The parotid gland can also be affected by an autoimmune disease. This is a chronic dry mouth which, in combination with other symptoms, forms the so-called Sjögren’s syndrome. Especially men are affected by the formation of so-called salivary stones (sialithiasis). The cause is often an altered saliva formation in connection with a change in the saliva composition. Painless swelling of the salivary glands usually occurs in connection with autoimmune diseases such as diabetes mellitus or hyperthyroidism. The intake of certain medications can also cause swelling of the salivary gland. Furthermore, ulcers may occur on the salivary gland.
Symptoms, complaints, and signs
Symptoms of parotid gland inflammation are usually sudden and severe. In addition, the symptoms are often unilateral. Only in mumps disease is there discomfort on both sides. Even if no symptoms have appeared yet, salivary glands may already be present. The size of the stone determines when the affected person starts to suffer from symptoms. In any case, the affected area swells, hurts and becomes hard. The symptoms increase when meals are taken, as this leads to increased saliva formation. The saliva in turn presses on the inflamed tissue. Due to the existing inflammatory process, the body usually also reacts with fever. The skin around the salivary gland becomes red and feels warm. If the inflammation is already advanced, pus may also be discharged into the oral cavity. If parotid gland disease is just a salivary stone, it may also pass without symptoms. Nevertheless, this area will swell.
Diagnosis and course of the disease
A thorough examination of the salivary gland is necessary to make a diagnosis. To differentiate whether it is merely a salivary stone or already an inflammation, the physician will take a thorough history. If pus leaks into the mouth when the gland is palpated, this is further evidence that inflammation is present. The doctor will swab the substance and initiate a laboratory test. This will help determine the bacteria responsible for the inflammation. A further examination of the oral cavity is also indicated, as this could provide clues as to the cause of the disease. A blood test is also possible. To differentiate between salivary stone, abscess or tumor, the doctor will order an ultrasound examination. The use of an MRI, CT or endoscopy are also possible examination methods. Another imaging procedure is sialography.During this procedure, the doctor injects a contrast medium. In the subsequent X-ray image, the ductal systems of the salivary gland can be visualized. In this way, insights can be gained into the size and location of salivary stones.
Complications
Patients usually suffer from severe swelling due to parotitis. This can also occur on both sides of the head and reduces the quality of life enormously. Furthermore, fever and a general feeling of illness also occur. Patients feel weak and listless and also suffer from the symptoms of a flu-like infection. Furthermore, there is redness and heating of the skin and salivary gland due to parotitis. Pus may be discharged in the oral cavity if the disease is not treated. In most cases, parotitis does not lead to any particular complications. Also, direct treatment is not necessary in every case, so in some cases parotitis can be complete without symptoms. Treatment of parotitis is carried out with the help of antibiotics and usually leads to success relatively quickly. There are also no complications. The patient’s life expectancy is also not negatively affected by parotitis.
When should you go to the doctor?
Pain in and around the ears should be examined by a doctor. Taking a pain medication is not recommended without consulting a medical professional. Complications and sequelae may occur, resulting in further weakening of health. Decreased hearing is a concern and must be presented to a physician. It is irrelevant whether the irregularity is unilateral or bilateral. The formation of pus is an alarming sign. If an unpleasant taste is perceived in the mouth or if there is a spread of inflammation, a doctor must be consulted. In the case of an unfavorable course of the disease, sepsis can occur, thus endangering the life of the affected person. If an increase in symptoms is noticed with increased salivation, a visit to the doctor is advisable. After eating or in other stimulating situations, a stimulation of the salivary flow takes place. This irritates the inflamed areas. An inner restlessness, malaise, disturbances of concentration as well as an increased body temperature are further signs of a health impairment. A visit to the doctor is necessary so that a diagnosis can be made and medical care can take place. Swelling in the area of the ears also indicates a disease that needs to be clarified.
Treatment and therapy
Therapy always depends on the trigger of the inflammation. In general, it is beneficial to stimulate the flow of saliva and thus flush the glands. Acidic lozenges and candies as well as liquids such as lemon juice help here. In the case of bacterial infestation, an antibiotic is prescribed. In the case of a viral infestation, painkillers and anti-inflammatory drugs can help. In this case, too, attention should be paid to thorough oral hygiene and rinsing of the gland. Abscesses and tumors can only be removed by surgery. Salivary stones, on the other hand, can be loosened by a so-called duct incision and massages if they are located in the initial area. Deeper stones with a maximum size of eight millimeters or those that cannot be palpated can be treated by the doctor with targeted sonication. In the best case, these break up and are transported to the outside via the saliva. Larger stones should also be surgically removed.
Outlook and prognosis
The prognosis of parotitis is favorable in most cases. If the disease is mild, the affected person can initiate recovery on his or her own. In these cases, salivation must be stimulated. This can be done independently by ingesting food. The increased salivary flow helps to alleviate the symptoms and can bring about spontaneous healing. In principle, cooperation with a physician should be sought even in the case of mild complaints in order to determine the stadium of the parotid gland disease and to be able to react immediately in the case of any changes. In case of more pronounced complaints, medication is administered. The administered agents help to kill the pathogens. Subsequently, they are transported away via the bloodstream of the organism and excreted.Within a short time, there is already relief of the symptoms and after a few days or weeks freedom from symptoms is documented. In the case of a very unfavorable course of the disease, the administered drugs remain ineffective. If the pathogens have already spread considerably or if the patient is at risk, surgery may be necessary. Surgery for this disease involves only a few steps, so that possible complications are very low. After the wound healing process, the affected person is normally discharged from treatment as symptom-free within a few weeks, even with this approach.
Prevention
The greatest risk of inflammation of the salivary gland is due to the formation of salivary stones. This can be easily prevented by ensuring adequate drinking and thorough oral hygiene. To clean the salivary glands, it is advisable to stimulate the flow of saliva using sugar-free sweets. In this way, small stones that are already present can also be rinsed out.
Aftercare
In parotitis, the affected person usually has only a few and also only limited options and measures of direct aftercare available. For this reason, a doctor must be consulted very early in this disease to prevent the occurrence of other complications and complaints. It is also not possible for parotitis to heal itself, so that the affected person is always dependent on a medical examination and treatment. Most sufferers are dependent on taking various medications for the disease. Antibiotics are also frequently taken, although the affected person should take care not to take them together with alcohol. In general, it is also important to ensure that the correct dosage is taken and that the medication is taken regularly in order to provide lasting relief from the symptoms. Regular checks by a doctor are also very important, as surgical intervention may also be necessary. After such an operation, the affected area must be particularly well protected to prevent infection or inflammation. Parotitis does not usually reduce the life expectancy of the affected person. Other measures and options for aftercare are not available to the patient in this case.
What you can do yourself
Drug treatment of parotitis can be positively supported with some home remedies. For example, patients should pay attention to soft food and sufficient fluid intake during therapy. This type of diet relieves the salivary glands and offers good prevention against salivary dryness. Pain relief can be provided, for example, by cooling compresses. In case of more intense pain, painkillers, so-called “rheumatism medicines” (for example: active ingredient diclofenac)can be resorted to. The consumption of sour candies or sour drinks (for example lemon juice) should accelerate the secretion of saliva. Massaging the affected parotid gland has the same effect. In this way, the formation of salivary stones is prevented. Existing, smaller salivary stones can also be secreted in this way. Doctors also recommend chewing sugar-free chewing gum to support therapy. After each meal, patients should clean their teeth intensively to ensure adequate oral hygiene. In addition, patients should also use mouthwash to clean hard-to-reach areas of the mouth with a toothbrush. Patients with acute parotitis are advised to give the body sufficient rest. Irradiation with red light also brings improvement.
