Surgical parotitis

Authors


  • Presented at the Meeting of the Middle Section, American Laryngologlcal, Rhinological and Otological Society, Inc., Omaha, Nebr., January 21, 1972.

  • From the Department of Otorhlnolaryngology, University of Nebraska Medical Center, Omaha, Nebr. 68105

Abstract

Surgical parotitis is an acute inflammation of the parotid gland which occurs in the postoperative period and carries a high mortality. The most commonly accepted mechanism is penicillin resistant staphylococci ascending through Stensen's duct. Eleven cases which occurred at the University of Nebraska and Omaha Veterans Administration Hospital between 1948-1971 were studied from the standpoint of etiology, treatment and prognosis. The disease was noted to occur in patients with poor oral hygiene and dehydration from six to 107 days postoperatively, but frequently appeared within two weeks. The disease manifested itself as a red, swollen, tender parotid gland, leukocytosis, and a low grade to moderate temperature elevation. Staphylococcus aureus was uniformly recovered in those cases which included culture. The organism was usually hemolytic and resistant to penicillin. Important points concerning prevention and treatment are outlined below.

Preventive Measures.

  • 1Making sure the patient has an adequate fluid intake.
  • 2Correction of nutritional and vitamin deficiencies.
  • 3Frequent gargles and mouth irrigations.
  • 4Pre-operative correction of dental caries, pyorrhea, and pharyngitis.
  • 5Minimal use of belladonna drugs pre-operatively.
  • 6Minimize trauma during anesthesia.
  • 7Discourage use of prophylactic-antibiotics.

Non-Operative Measures.

  • 1Correction of dehydration, nutritional metabolic and vitamin deficiencies.
  • 2Warm, moist packs.
  • 3Lemon or orange juice to stimulate salivary flow.
  • 4Mouth irrigations.
  • 5Antibiotics.
  • 6Irradiation, 75R to gland daily for five days, has been used in selected cases with success.

Operative.

Incision and drainage of the gland parenchyma.

Prognosis depends upon the basic disease entity and response to measures for parotitis.

Ancillary