What is parotitis?

The main salivary glands on the face, located behind the jaw, are called the parotid glands. These glands secrete an enzyme called alpha-amylase, which begins the process of breaking down starches as food is chewed in the mouth. Very few medical conditions are associated with these glands; The most common is an inflammatory disease called parotitis.

Swelling of the parotid gland is usually the result of an infection. More rarely, the inflammation can be caused by an autoimmune disease. There is also a nonspecific form of parotid disease that causes chronic inflammation with apparently no underlying cause.

Symptoms of the condition include painful swelling and redness of the skin over the gland. The pain is exacerbated by chewing, and the glands are tender to the touch. When the cause of the inflammation is a bacterial infection, the saliva is usually yellow in color and thicker than the saliva secreted by a healthy gland. If the swelling is not caused by an infection, the saliva may be normal or nearly normal in color and viscosity.

Infectious parotid swelling is commonly caused by a viral infection with mumps, which often also causes fever, headaches, and testicular swelling. Infectious parotitis can also be caused by a bacterial infection; In most cases, the infectious agent is Staphylococcus aureus . People with HIV or tuberculosis are at increased risk of infectious inflammation of the parotid gland. These infections can also cause recurrent parotitis, in which the gland is constantly inflamed or susceptible to repeated bouts of infection.

While some cases of recurring inflammation are associated with infection, most occur in conjunction with an autoimmune disease. When the inflammation has an autoimmune cause, the most likely condition is Sjogren's syndrome. This disease usually develops in people between the ages of 40 and 60, but it can also occur in children. Autoimmune inflammation of the parotid gland develops as a result of sensitization of immune cells to cells of the parotid gland. The immune system mounts an attack on the parotid cells, causing chronic or recurrent inflammation.

Treatment of parotitis is usually limited to providing relief from pain and tenderness of the parotid glands. When the inflammation is an isolated case caused by an infection, sufficient treatment may include pain medication, adequate hydration, and the application of heat. In most cases, the mumps infection resolves without further treatment. If the inflammation is caused by a bacterial infection, antibiotic treatment is often used in conjunction with symptomatic relief.

Chronic or recurrent cases of parotitis can also be treated this way, if the episodes are not severe. Some people opt for surgery to remove or alter chronically swollen parotid glands, due to the highly unpleasant nature of chronic symptoms. The most common surgery performed for this condition is one in which the outer portion of the gland is removed, leaving the so-called deep lobe intact, which is usually not involved in the infection.

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