ABSTRACT
@#Chronic obstructive diseases of the parotid gland are common clinically, with repeated swelling and a prolonged course and poor treatment outcomes. Based on the summarization of clinical practice and related literature, from the viewpoint of etiology, parotid obstructive diseases can be classified as mechanical obstructions, specific obstructions and non-specific obstructions. The principles of fluid mechanics are introduced to explain the formation of parotid obstructions. According to the different causes, the methods of changing the flow pattern of saliva in the parotid to reduce the resistance and relieve the obstruction, are proposed, such as mechanical factors removals, application of drugs that promote saliva secretion and lower saliva viscosity, ductal expansion under endoscopy and stent placement, and embolization of collateral ducts. These managements can effectively increase the salivary flow rate, reduce the occurrence of the saliva stranded and parotid gland obstructions.
ABSTRACT
BACKGROUND AND OBJECTIVES: Chronic recurrent parotitis has been considered as an ascending infection from the oral cavity, but its causes remain unknown. Although conservative mechanical and medical measures are usually effective in controlling the acute exacerbations of this disease, surgical treatment may become necessary when the infection become too frequent or severe for episodic treatment. This study was designed to evaluate the etiology and pathology, and to analyse the outcome of surgery. MATERIALS AND METHODS: A retrospective study was conducted on nine patients who were managed by surgery(seven patients: superficial parotidectomy, two patients: total parotidectomy) after failure with all conservative measures. The age distribution was from 25 to 72 years, with the mean of 44 years. RESULTS: Of nine patients, the numbers of recurrence were 1-5 times (with the average of three times). Duration of illness ranged from one to 42 years, with a mean of 12 years. Conservative treatments preceding surgery included parotid gland massage, sialogogues, repeated use of antibiotics, and Stensens duct probing in all patients. The disease persisted in all the patients despite these measures, but following parotidectomy (superficial: 7 patients, total: 2 patients), all had complete resolution of the disease. Two patients developed transient facial weakness (House-Brackmann grade II) postoperatively without permanent sequelae. Other complications included seroma in two patients, facial deformity in two patients, Freys' syndrome in one patient, and salivary fistula in one patient. CONCLUSION: Chronic recurrent parotitis, when deeply severe, causes significant. When all the conservative medical management fail, parotidectomy can be offered as the last resolution.