Pneumoparotitis
Pneumoparotitis (also termed pneumosialadenitis[1] wind parotitis,[1] surgical mumps,[2] or anaesthesia mumps),[2] is a rare cause of parotid gland swelling which occurs when air is forced through the parotid (Stenson) duct resulting in inflation of the duct.
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Signs and symptoms
The size of the swelling is variable, but it is soft[3] and can occur on one side or both sides.[1] It is typically non tender,[3] although sometimes there may be pain.[1] It usually resolves over minutes to hours, however occasionally this may take days.[1] The condition can be transient or recurrent.[4]
Causes
The condition is caused by raised air pressure in the mouth. [1]
Diagnosis and management
Pneumoparotitis is often misdiagnosed and incorrectly managed.[4] The diagnosis is based mainly on the history.[1] Crepitus may be elicited on palpation of the parotid swelling,[1] and massaging the gland may give rise to frothy saliva or air bubbles from the parotid papilla.[1] Further investigations are not typically required, however sialography, ultrasound and computed tomography may all show air in the parotid gland and duct.[1]
Management is simply by avoidance of the activity causing raised intraoral pressure which is triggering the condition.[1]
Prognosis
Recurrent pneumoparotitis may predispose to sialectasis, recurrent parotitis, and subcutaneous emphysema[4] of the face and neck, and mediastinum, and potentially pneumothorax.[1]
Epidemiology
The condition is rare.[4] It is more likely to occur in persons who regularly have raised pressure in the mouth, for example wind instrument players,[5] and balloon[1] and glass-blowers.[6] Cases have also been reported with bicycle tyre inflation,[1] whistling,[1] nose blowing,[1] cough[1] and valsalva manoeuvre to clear the ears.[1] It can be an iatrogenic effect of dental treatment,[1] spirometry,[1] and positive pressure ventilation.[2] Apart from these factors, the condition mainly occurs in adolescents, often self-inflicted due to psychological issues.[6][7]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 Lua error in package.lua at line 80: module 'strict' not found.
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- ↑ 3.0 3.1 Lua error in package.lua at line 80: module 'strict' not found.
- ↑ 4.0 4.1 4.2 4.3 Lua error in package.lua at line 80: module 'strict' not found.
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