Parotid gland enlargement
Introduction
Introduction The anterior boundary of the parotid gland is the anterior border of the mandibular branch, the posterior border is the upper kyphosis of the sternocleidomastoid and the external auditory canal. The upper boundary is the lower edge of the zygomatic arch, the lower boundary is the lower mandibular angle or lower than the mandibular angle l-2cm. There are many causes of swelling of the parotid gland, which may be diseases of the parotid gland itself, local signs of systemic diseases, or diseases of non- parotid tissues such as chewing muscles.
Cause
Cause
(1) Tumor and tumor-like lesions in the parotid gland
1. Benign tumors include pleomorphic adenomas, adenolymphomas, and myoepithelial tumors.
2. Malignant tumors: primary malignant tumors such as epidermoid carcinoma, adenoid cystic carcinoma, squamous cell carcinoma, acinar cell carcinoma, malignant pleomorphic adenoma, and metastatic carcinoma of the parotid gland.
3. Tumor-like lesions include the first cleft palate, parotid cyst, eosinophilic lymphogranuloma, parotid hemangioma and vascular malformation.
(B) inflammatory parotid swelling
1. Acute inflammation: such as mumps, acute suppurative mumps, parotid lymphadenitis, etc.
2. Chronic inflammation: chronic suppurative mumps, parotid tuberculosis, actinomycosis in the parotid gland.
(3) Parotid swelling caused by other causes
Such as benign hypertrophy of the parotid gland, drug-responsive enlargement, and some syndromes such as Sjogren's syndrome, uveal gland heat, etc. caused by parotid swelling.
(D) non- parotid diseases: such as benign swelling of the chewing muscles, infections under the chewing muscles.
Examine
an examination
Related inspection
Mumps virus antibody ear, nose, throat swab bacterial culture serous effusion anti-keratin antibody anti-keratin antibody (AKA)
(1) Physical examination
1. Local examination: epidemic mumps, suppurative mumps local tenderness, catheter opening can be red and swollen, but the former squeezes the parotid gland out of the clarified liquid, while the latter flows out of the turbid pus. Benign and malignant tumors of the parotid gland, no tenderness, no redness and swelling of the catheter opening. Benign masses are enveloped, active, and moderately hard. Malignant tumors are hard and inactive.
2. Systemic examination: Qualified lunester syndrome is often accompanied by lacrimal gland hypertrophy and connective tissue disease.
(2) Laboratory inspection
In acute paroxysmal inflammation of the parotid gland, the total number of white blood cells and neutrophils increased, and the number of white blood cells was low in mumps and Sjogren's syndrome. The person with eosinophilia is allergic mumps. Rheumatoid factor and antinuclear antibody positive monthly globulin increased, serum lgG increased in Sjogren's syndrome.
(c) parotid angiography
Parotid angiography is of great value in the diagnosis of parotid inflammation, benign and malignant tumors, and qualifiers.
(4) Biopsy
For patients suspected of having tumors, preoperative acupuncture biopsy and intraoperative frozen section examination are important for the diagnosis and guidance of surgery.
Diagnosis
Differential diagnosis
It should be differentiated from the following symptoms:
Painless mass of parotid gland
Basal cell adenomas present as a painless mass of the parotid gland. The tumor grows slowly, has a long course of disease, has no symptoms, and often visits with a painless mass. The tumor has clear boundaries and no adhesion to surrounding tissues. Mostly round or oval, the texture is soft.
2. Parotid swelling
The anterior boundary of the parotid gland is the anterior border of the mandibular branch. The posterior border is the apical apex of the sternocleidomastoid and the external auditory canal. The upper boundary is the lower edge of the zygomatic arch. The lower boundary is the lower mandibular angle or l-2 cm below the mandibular angle. There are many causes of swelling of the parotid gland, which may be diseases of the parotid gland itself, local signs of systemic diseases, or diseases of non- parotid tissues such as chewing muscles.
3. Acute purulent mumps (Acute purulent parotitis)
It has been common in large abdominal surgery, so it is also called postoperative parotitis, which is one of the serious complications. Due to the development of antibiotic applications and attention to maintaining normal access and water and electrolyte balance, it is currently rare. In addition to this, acute inflammatory patients with parotid glands are still seen.
4. Parotid gland enlargement
The swelling of the parotid gland is often the first sign of the disease. It lasts for 7-10 days. The common side is swollen for 2-3 days. The contralateral parotid gland also appears swollen. Sometimes the swelling is only unilateral, or the parotid gland enlarges and the submandibular gland enlarges. Or even the submandibular glands are swollen without parotid gland enlargement. Pain, chewing, especially when eating acidic foods.
