Obstructive Parotitis Research Articles

Causes of chronic obstructive parotitis and management by sialoendoscopy

Sialoendoscopy is a relatively new technique to detect causes of obstruction in the parotid gland directly and manage the chronic obstructive parotitis effectively combined with continuous lavage and drug perfusion simultaneously. To describe the cause, exploration, and combined management of chronic obstructive parotitis using sialoendoscopy. Between October 2004 and June 2006, 23 patients with obstructive symptoms were diagnosed by sialography and explored by diagnostic sialoendoscopy. The obstructions were then removed by interventional sialoendoscopy. After obstructions were removed successfully, 0.25% chloramphenicol was used to lavage the duct continuously, and then 40% iodized oil was perfused into duct. The results of follow-up were evaluated by visual analog scales (VAS) of the clinical appearances at different stages. Twenty of the 23 patients were found with various types of stenosis and dilatation of duct on sialography, and 21 patients were explored using sialoendoscopy successfully. The features of these 21 cases found endoscopically were of 4 types: sialolith (n = 4; 19.0%), duct polyps (n = 5; 23.8%), stenosis (n = 3; 14.3%), and mucus plug (n = 9; 42.9%). Seventeen cases were treated successfully, removing obstructions via sialoendoscopy, giving a success rate of 80.9% (17 out of 21). The satisfactory rate after 6 months was 82.4% by VAS and secretion observation. Sialoendoscopy is a promising image-guided technique for evaluation and treatment of obstructive disease of the parotid salivary glands.

Squamous cell carcinoma arising from Stensen's duct

We report a case of squamous cell carcinoma presumably arising from the left Stensen's duct. The tumor was discovered during management of recurrent left parotitis. Ultrasonography, computed tomography, and magnetic resonance imaging were useful for estimating the tumor and coexisting obstructive parotitis. Relapsing symptoms and the presence of parotitis seemed to be characteristic of tumors of Stensen's duct. For a mass accompanied by obstructive parotitis or relapsing parotitis without salivary calculus, a tumor of Stensen's duct should be included in the differential diagnosis.

Sialoendoscopic and Irrigation Findings in Chronic Obstructive Parotitis

To study the sialographic changes related to sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis. The sialographic changes were classified according to previous studies and related to sialoendoscopic and irrigation fluid findings. This study included 26 patients with a long history of parotid swelling. All patients were examined by radiography and sialography and were diagnosed as having chronic obstructive parotitis without sialolithiasis. Sialoendoscopy was used to observe the ductal system and perform an irrigation treatment. The irrigated liquid was centrifuged, and the fluid deposits were stained and observed using light microscopy. In all cases, sialoendoscopic examination showed the ductal system was filled with fiber-like substances and hyperemia of the ductal wall. Although a few of the thin and short fiber-like substances were found in the chronic obstructive parotitis patients with sialographic type I and type II changes, many thick and long wadding or lumpy fiber-like substances were revealed in chronic obstructive parotitis patients with sialographic type III and IV changes. Microstones were found in two chronic obstructive parotitis patients with sialographic type III changes, which were stained and identified using light microscopy. Irrigation fluid examination showed that the fiber-like substance was composed of desquamative duct epithelial cells, neutrophils, lymphocytes, and acidophils. Also, some epithelial cells were found in two microliths. Sialoendoscopy can provide direct and more detailed observation of the ductal system compared with sialography. Fiber-like substances in the lumen of the ductal system are considered one of the obstructive factors associated with chronic obstructive parotitis.

Obstructive parotitis after rhytidectomy: case report

Obstructive parotitis after rhytidectomy: case report

Gland atrophy following retrograde injection of methyl violet as a treatment in chronic obstructive parotitis

Objective. The purpose of this study was to evaluate the clinical effectiveness of retrograde injection of 1% methyl violet as a treatment for chronic obstructive parotitis. Study Design. Sixteen patients with chronic obstructive parotitis were treated with retrograde injection of 1% methyl violet. Pretreatment evaluation and assessment of the treatment effect were performed by clinical and imaging methods, including sialography and sonography of the treated glands. Results. Clinical symptoms following treatment included initial acute swelling and then a decrease in parotid swellings; the final outcome was a clinical cure of the affected glands characterized by disappearance of all symptoms, absence of secretion, and complete obliteration of the main duct orifice. Posttreatment imaging showed total atrophy of the diseased glands. Conclusion. Retrograde injection of 1% methyl violet caused total atrophy of the diseased glands and brought about complete relief in all 16 patients, with no detectable side effects.

Histopathologic findings in a case of recurrent parotitis in adulthood

Most cases with recurrent parotitis in childhood (RPC) can be cured before puberty. 1–3 A few of them, however, may continue to adulthood. 1–4 To distinguish this condition from other types of chronic parotitis in adults, such as chronic obstructive parotitis, 5 we suggest that the diagnosis of recurrent parotitis in adults (RPA) be reserved for the cases derived from RPC. 6 The pathophysiology and development of RPA is still not well known. To our knowledge, there are few reports of RPA in the literature, especially concerning its histopathology. This report describes a cases of RPA studied with sialography and light and electron microscopy.

Sialographic changes related to clinical and pathologic findings in chronic obstructive parotitis

This paper presents the results from a study of 23 patients with chronic obstructive parotitis (COP) in whom the sialographic changes were related to the clinical and histopathologic features. The sialographic changes were divided into four types. The stimulated parotid flow rate (SPFR) was normal in sialography Type I patients, while SPFR was significantly reduced in Types II, III, and IV patients, as compared with healthy persons. The changes observed by light microscopy were irregular dilation and chronic inflammation of main and branching ducts with saliva deposits in the enlarged luminal system. Ultrastructural changes included degeneration of ductal epithelial cells, marked proliferation of periductal fibrous tissue, and moderately electron-dense deposits in the lumen of the dilated peripheral ducts. The extent of the histopathologic changes largely paralleled the severity of the sialographic changes. These findings indicate that COP is a relatively common inflammatory disease and that the sialographic classification reflects the severity of the disease.

Sequential quantitative scintigraphy of parotid glands with chronic inflammatory diseases

A practical, time-saving procedure for sequential quantitative scintigraphy is introduced and 4 parameters chosen from 12 parameters by discriminant analysis are used to evaluate the function of the parotid gland. The examination was performed in 120 cases, including 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis (COP), 37 with Sjögren's syndrome (SS), 4 with sialadenosis, and 30 normal controls. The scintigraphic findings were analyzed and compared with the histologic findings. The diagnostic value of this method was investigated and scaling for differential diagnosis of COP and SS was established. Scintigraphy is considered to be a useful method for evaluation of parotid function and as a diagnostic aid for SS and COP, especially in patients in whom sialography cannot be performed.

Chronic obstructive parotitis: Report of ninety-two cases

Clinical, siolographic, and sequential quantitative scintigraphic characteristics of 92 cases of chronic obstructive parotitis (in 117 diseased parotid glands) are reported, and the treatment investigated. The cardinal feature of this disease is obstruction or retarded salivary flow resulting in recurrent swellings and retrograde infection. The main characteristic seen in sialograms is irregular dilation of the main and branching ducts. On the basis of sialographic findings, the ducts are classified into four types. This classification reflects the severity of the disease and can also be used as a guide to treatment.

Lactoferrin and lysozyme in carcinomas of the parotid gland

Lactoferrin and lysozyme, parts of the non-specific defense system, were studied in normal and diseased parotid glands, using the immunohistochemical PAP-method. 31 normal and inflamed glands were investigated. The presence of lactoferrin and lysozyme was demonstrated in the acinar cells and some duct cells. The amount of these substances was increased in obstructive parotitis. The 52 carcinomas showed a distinct distribution pattern for lactoferrin (positive cases: adenocarcinomas 5 of 8; cystadenocarcinoma: 3 of 5; adenoid cystic carcinomas 2 of 4; salivary duct carcinomas 2 of 3). Some of the carcinomas in pleomorphic adenomas were positive for lactoferrin. Squamous cell carcinomas and anaplastic carcinomas were constantly negative. All carcinomas were negative for lysozyme. These observations are discussed with respect to their physiological and pathological significance.

Presence of carcinoembryonic antigen (CEA) in the normal and inflamed human parotid gland. An immunohistochemical study of 31 cases.

Carcinoembryonic antigen (CEA) was analysed in the human parotid gland. Specimens of 31 normal and inflamed parotid glands were studied by the indirect immunoperoxidase technique. The presence of CEA could be demonstrated at the border of the acinar cells and the intercalated duct cells as well as in the undifferentiated duct cells as observed in chronic obstructive parotitis. These observations may explain the presence of CEA in normal human saliva and may provide a new basis for histogenetic interpretation of pathological lesions of the parotid gland, especially of the tumors of the salivary gland tissue.