Pediatric salivary gland imaging

Abstract

Sir, We read with great interest the pictorial essay on pediatric salivary gland imaging by Boyd et al. [1]. They have shown excellent radiological images of the wide spectrum of pediatric salivary gland disorders. However, we would like to point out an error in one of the figures (Fig. 2 in [1]) presented as accessory parotid gland. The images show contiguous extension of the superficial lobe of parotid gland draping the masseter muscle. Accessory parotid gland tissue has been described as salivary tissue lying adjacent and above the Stenson’s duct that is distinctly separate from the main body of the parotid gland [2]. This fact is highlighted in Fig. 1. In a postmortem study by Frommer [3], the prevalence of accessory parotid glands was reported to be 21%. The accessory gland typically lies anterior to the parotid gland along the masseter muscle and the average distance between the main parotid gland and the accessory parotid gland is 6.0 mm [3, 4]. Thus, the axial MR image (T2-W) in the paper by Boyd et al. [1] shows an enlarged superficial lobe of bilateral parotid glands draping over the masseter muscle rather than an accessory parotid gland. We also think that an important entity called chronic recurrent parotitis (CRP) of childhood has been omitted. CRP is the most common inflammatory disease next to mumps affecting the salivary glands in the pediatric population. A radiologist is likely to see CRP far more commonly than some of the very rare entities illustrated. CRP, also known as juvenile recurrent parotitis, is characterized by recurrent episodes of unilateral or bilateral parotid swelling, usually accompanied by pain, fever and malaise. The onset of disease is in early