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. 2022 Apr;42(2):106-115.
doi: 10.14639/0392-100X-N1837.

Treatment for parotid abscess: a systematic review

Alberto Maria Saibene #  1   2 , Fabiana Allevi #  1   3 , Tareck Ayad  1   4 , Jérome R Lechien  1   5 , Miguel Mayo-Yáñez  1   6   7 , Krzysztof Piersiala  1   8 , Carlos M Chiesa-Estomba  1   9
Affiliations

Treatment for parotid abscess: a systematic review

Alberto Maria Saibene et al. Acta Otorhinolaryngol Ital. 2022 Apr.

Abstract

Trattamento degli ascessi parotidei: revisione sistematica della letteratura.

Riassunto: Gli ascessi parotidei rappresentano una complicanza della parotite. Questo studio mira a definire i concetti moderni di trattamento di questa patologia e le diverse scelte di gestione. È stata eseguita una revisione sistematica della letteratura secondo il protocollo PRISMA degli studi originali sul trattamento degli ascessi parotidei, pubblicati sino al Gennaio 2021. Gli studi riportanti modalità di trattamento e tasso di successo sono stati inclusi dopo selezione basata su abstract e full-text, valutando qualità degli studi, caratteristiche dei pazienti, tasso di successo, modalità di trattamento ed eventi avversi. Su 1318 citazioni, 18 studi rispettavano i criteri di inclusione, 12 basati su incisione e drenaggio e 6 comparanti diversi trattamenti (incisione e drenaggio versus terapia medica esclusiva o drenaggio eco-guidato). L’eterogeneità degli studi non ha consentito la realizzazione di una meta-analisi. Gli antibiotici si confermano il punto fermo del trattamento degli ascessi parotidei. Il ruolo di drenaggi chirurgici ed eco-guidati dovrebbe essere invece maggiormente esplorato. Il maggiore tasso di complicanze dopo incisione e drenaggio suggerisce un approccio più conservativo. Incisione e drenaggio restano la principale risposta al fallimento della terapia conservativa.

Keywords: antibiotics; drainage; parotitis; salivary gland; sialadenitis.

Plain language summary

A parotid abscess is a dangerous complication of parotitis. In this study, we aimed to define current treatment concepts for parotid abscess, focusing on different management options. The authors performed a PRISMA-compliant systematic review across multiple databases including all original studies published until January 2021 focusing on treatment of parotid abscess. Studies specifying treatment modalities and treatment success rates were included based on abstract and full-text selection. The authors assessed study quality, demographics, success rates, management modalities and adverse events. Among 1,318 citations, 18 studies met our inclusion criteria. Twelve studies relied only on incision and drainage with antibiotic therapy; the remaining 6 compared different treatment modalities (incision and drainage versus exclusive medical therapy or ultrasound-guided drainage). Heterogeneity between studies precluded meta-analysis of data. The review showed that antibiotics remain the mainstay of treatment for parotid abscess. Conversely, the role of incision and drainage, and aspiration should be studied further. The higher rate of complications following incision and drainage suggests a more conservative approach is needed. Incision and drainage remain the main salvage option for conservative treatment failures.

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Figures

Figure 1.
Figure 1.
PRISMA flow diagram of study selection through systematic review.
Figure 2.
Figure 2.
Geographical representation of the countries of origin of the reviewed articles (in green: one article only; in blue: two or more articles).
See this image and copyright information in PMC

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