Recurrent pneumoparotid: cause and treatment

Abstract

Objective: To document the etiology and successful treatment of severe recurrent pneumoparotid.

Study design: Computed tomography, ductal measurement by probe size, surgical treatment.

Results: We performed a superficial parotidectomy for a 13-year-old with a history of recurrent parotitis. He subsequently developed recurrent pneumoparotid in the contralateral gland with subcutaneous dissection of air into the face, neck, and mediastinum. At surgery, Stensen's ducts were measured and found to be abnormally patent bilaterally compared to standardized norms. Parotid duct ligation, commonly used for sialorrhea, was employed as a novel treatment and was curative.

Conclusion: Insufflation of air into the parotid duct system can trouble woodwind instrument players, can complicate dental procedures, or can be self-induced. It is generally a benign condition requiring no therapy. Occasionally, pneumoparotid can be recurrent and lead to inflammation and infection of the parotid or subcutaneous emphysema.

Significance: In selected cases of recurrent pneumoparotid, ductal ligation may be curative.