Swelling of the parotid gland

What is meant by swelling of the parotid gland?

The parotid gland (Glandula parotis) is located on both sides of the cheeks under the skin and is one of the largest salivary glands in humans.
Swelling of the parotid gland swells the cheek strongly and under the skin a bumpy protrusion is felt.

Either the swelling occurs unilaterally or affects both salivary glands. The swelling is caused by inflammation with pathogens or has non-inflammatory causes.

Causes of swelling of the parotid gland

Swelling of the parotid gland is usually caused by inflammation. By infection with bacteria, the parotid gland inflames, swells and it comes to a purulent parotitis. A typical bacterial pathogen is Staphylococcus aureus, which migrates up through the duct of the salivary gland in the mouth into the gland.

Often, the duct is laid by a salivary stone, whereby the saliva can no longer flow away and the bacteria can easily multiply in it.

The same thing happens when a tumor or scarring obstructs the duct.

Inflammation of the parotid gland (parotitis) can also be caused by various viruses, such as neurotropic paramyxoviruses, Epstein-Barr virus or influenza viruses.

In all cases, the parotid gland swells and hurts. Especially in small children swelling of the parotid gland is often caused by a viral infection with the mumps virus. In addition to sore throat and fever, there is swelling of the parotid gland on both sides. Most children nowadays receive a standard vaccination against mumps.

There are also non-inflammatory causes of a swollen parotid gland. The swelling can be a side effect of drugs that reduce the flow of saliva (eg beta-blockers in heart problems, diuretics, antidepressants or antihistamines).

Also, various disorders of the metabolism, such as metabolic diseases (hyperthyroidism, diabetes mellitus), malnutrition or alcohol addiction cause swelling of the salivary gland.

Another cause is the Sjögren syndrome. It is an autoimmune disease in which it comes to a strong dry mouth.

Diagnosis of a swollen parotid gland

The doctor scans the swelling and takes a blood sample to determine if inflammation has caused the swelling.

In some cases, the doctor may also take a swab to accurately determine the pathogen.

The diagnosis of a swollen parotid gland is confirmed by means of an ultrasound examination. It can be determined whether the swelling is caused by a salivary stone, constrictions or a tumor.

Accompanying symptoms

Depending on the cause, either only one or both parotid glands may be swollen. The swelling usually occurs quite suddenly and can be felt as protrusion in front of or under the ear.

As accompanying symptoms of swelling, pain and a feeling of pressure may occur. The pain can radiate into the teeth and the temporomandibular joint.
In the case of an inflamed parotid gland, redness develops in the affected area in addition to the swelling.

The skin over the salivary gland feels warm and can stretch. A pronounced swelling of the parotid gland may cause difficulty in opening the mouth. Patients are then severely impaired when talking, and especially when eating and chewing and sometimes have severe pain.

Prolonged inflammatory swellings of the parotid gland may cause complications: the inflammation may become obscured and form a pus-filled cavity within the parotid glands. One speaks then of an abscess.

Swelling of the parotid gland with pain

A swelling of the parotid gland, which is associated with pain, speaks for an inflammation as a cause. The cheek on the affected side is usually red, warm and those affected may have a fever.

The inflammation is caused by viruses or bacteria and may affect one or both parotid glands.

Painless swelling of the parotid gland

A painless swelling of the parotid gland means that there is no inflammation and is referred to as sialadenosis or sialosis.
As long as the function of the masticatory muscles and speaking are not impaired by the swelling, the swelling does not necessarily have to be treated.
Many sufferers, however, find the swollen parotid gland visually distracting and therefore still seek out a doctor.

Common causes of sialadenosis are various metabolic disorders, such as diabetes mellitus or an overactive thyroid, or a protein or vitamin deficiency.

Often, non-inflammatory swelling of the salivary glands also occurs as a side effect of various drugs.

Swollen lymph nodes

Lymph node swelling is a sign of infection and immune reaction in the body. An inflamed parotid gland swells the lymph nodes in the area.

The swollen lymph nodes are clearly palpable in front of and behind the ears, under the jaw and along the neck muscle.

Which doctor is treating this?

Patients with swelling of the parotid glands are best looked for by an ear, nose and throat doctor (ENT specialist).
ENT specialists have the diagnostic and therapeutic options to diagnose a disease and prescribe the appropriate therapy. Larger cities have their own salivary gland centers specializing in salivary gland diseases.

Treatment and therapy

The treatment of a swollen parotid gland depends on the cause. Inflammatory swelling is often caused by salivary stones.
The salivary stone displaces the excretory duct of the gland and can be removed either surgically or by mini-endoscopy of the salivary ducts.

  • Very large stones must first be crushed by ultrasonic waves, this procedure is called extracorporeal shockwave lithotripsy (ESWL).
  • Smaller stones may also be removed by a massage of the gland.
  • If the swelling of the parotid gland is an infection, the inflammation must be treated as quickly as possible. Left untreated, the body can capsulate the inflamed tissue and pathogens, forming a purulent abscess in the parotid gland, which must be surgically removed.
  • A bacterial infection is treated by antibiotics. In addition, the doctor prescribes analgesic and anti-inflammatory drugs such as ibuprofen or acetaminophen.
  • In a viral infection (eg mumps, influenza viruses), only the symptoms can be treated, that is, it is prescribed antipyretic and analgesic drugs.
  • In chronic and recurrent inflammation of the parotid gland or in suspected malignant tumor disease, the parotid gland can also be surgically removed (parotidectomy).

Which home remedies can help?

In general, a doctor should be consulted if there is a prolonged swelling of the parotid glands or in case of pain. The doctor can make the exact diagnosis and find the cause of the swelling.
In addition to the prescribed medicines and antibiotics, there are also some home remedies, which also help that the parotid glands swollen as quickly as possible.

Patients are advised to drink plenty of fluids to keep the mouth dry and the bacteria to grow more difficult. Chewing gum and sugar-free candies stimulate salivation and thereby accelerate healing.

The most common cause of swelling of the parotid gland is a bacterial infection.
A targeted strengthening of the immune system through sufficient sleep, a balanced diet and regular exercise can contribute to accelerated healing.

In addition, regular and careful oral hygiene helps prevent the bacteria from spreading.

homeopathy

Swelling of the parotid gland, which is caused by a bacterial infection, must be treated with antibiotics in most cases, since otherwise serious complications (formation of an abscess) can occur.

In addition, patients may take homeopathic remedies to speed healing.

Among the homeopathic treatment options for a swollen parotid gland is the therapy with Arsenicum album and Chamomilla.
However, the treatment should be individually adjusted by a homeopath or naturopath.

Duration of parotid swelling

The duration of parotid swelling depends primarily on the cause.
A bacterial infection is treated with antibiotics and the swelling goes back within a few days and usually heals easily.
The removal of the salivary stones is a routine procedure and after a few days the patients no longer have any complaints.


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