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Forum Name: Rheumatology Topics

Question: Parotid Gland Swelling


 medgrl7 - Sun Nov 20, 2005 3:17 am

I have lived with myy face swelling up on both sides for 3 years. I have been to many ENT specialists and none can say what is causing it. I noticed coffee is a big problem for me, but other things I eat cause them to swell. When I push on the area and hard to, the puss or crystalized saliva comes though my cheek and into my mouth. My face will still continue to swell until I push all of the strands through. I have such severe pain that I dreed waking up in the morning. The doctors would like to do surgery on both sides of my face but the results are unknown. I cannot figure out why this happens and what has caused it. I used to live off of coffee and did not drink much fluids but, not it seems like it will never let me live my life. I am 25 and have missed 2 years of going out and enjoying myself. I no longer drink starbucks because it scares me to death. I need a doctor who will try to save my face. Every doctor I see has made me feel like I have no hope besides surgery. No stones were detected and cancer was not something either. I am so confused because I would rather have a diagnosis then to wonder or to do surgery on a what if. PLease help me someone find a reason or a cure to help this pain. Everyday I wake up and say I hate my cheeks. I want to wake up and do my day the way I used to. I would appreciate any imput cause thats all I have left. Thank you so much for your time- Ashley
 Dr. Safaa Mahmoud - Thu Aug 10, 2006 9:31 pm

User avatar Dear medgrl7,

It would be useful if you can inform us about all the investigations that have been done and their results. Your past history and past diagnoses of any systemic or local diseases are also important.

Causes of parotid enlargement involve a wide range of local and systemic diseases and disorders including:

Chronic Sialadenitis
– This is usually due to the presence of calculi or stenosis of the ducts secondary to permanent damage after an attack of acute infection.

Manifestations include recurrent attacks of mild pain, with recurrent parotid enlargement that worsens with eating .

Investigations include:
CBC may show changes suggestive of infection or inflammation during the attack.
ESR and CRP to exclude inflammatory syndromes. CXR to exclude other LN enlargement.
Plain x-ray may show a radio-opaque stone in a salivary duct.

Treatment include:
1) treatment of the underlying causes
2) Sialogogues, massage, heat, and hydration
3) Periodic duct dilatation
4) Excision

- Some tumours like MALT lymphoma affects the parotid gland and CT scan is of choice in the diagnosis in addition to the previous investigations.

FNA, Open Biopsy and surgical removal are often avoided.
 medgrl7 - Tue Jun 22, 2010 12:11 am

Thank you for your response. It has now been 8 years I have lived with this condition. I have not found any known cause that has made any sense of my facial swelling. I am writing this tonight with both sides of my face swollen. My physican has tested me for several things including cat scratch fever, HIV, infection which came back elevated but does not respond to antibiotics. I have noticed the pressure from my face has caused my ears to pop and now I suffer with TMJ. I am afraid of my future and want to know what will happen to my parotid glands if they continue to swell and untreated and will this continue to happen for the rest of my life?
 Dr.M.jagesh kamath - Fri Jun 25, 2010 5:03 am

User avatar Hello,Minimally invasive sialoendoscopy has replaced previous difficult surgical procedures in chronic obstructive parotitis.After a sonography and confirming if if there are strictures or stenosis(Which are commonly seen in the adult form in contrast to juvenile types)if treatment with silogouges and parotid massage fails,this is tried.This has proved to be a successful procedure.This is both diagnostic and therapeutic.Stents may be used to relieve obstruction.
Do consult a oral surgeon for further evaluation.
Best wishes.

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