[Clinical aspects of abscess development in parotitis]

Abstract

Objective: The purpose of this paper was to analyse parotideal abscesses on the basis of a larger number of patients.

Patients and methods: The data of 36 patients (mean age 44 years) with a parotideal abscess was analysed.

Results: Ultrasound scan was always necessary to verify the diagnosis. The surgical drainage was done under myoelectric monitoring of the facial nerve. Only in 1 patient a temporary minor paralysis of the mandibular branch was noticed. The most common bacteria were Staph. aureus, Streptococcus, and Peptostreptococcus. In 2 cases a tuberculosis and in 2 children an atypical mycobacterial infection was discovered. In another patient a metastasis of a squamous cell carcinoma was found.

Conclusions: In every patient with an acute swelling of the parotid region without consideration of age, number of leucocytes or a typical fluctuation, an ultrasound scan should be used. The surgical drainage of the abscess should be done under myoelectric monitoring (Cave: muscle relaxant). In every case, a specimen for microbiological analysis (bacterial determination) and a biopsy (to exclude malignoma or atypical mycobacteria) are necessary. A peri- and post-operative therapy with a combination of aminopenicillin and clavulanic acid or with cephalosporine is recommended.