Pneumoparotitis (also termed pneumosialadenitis[1]wind parotitis,[1]surgical mumps,[2] or anaesthesia mumps),[2] is a rare cause of parotid gland swelling which occurs when air is forced through the parotid (Stensen) duct resulting in inflation of the duct.[3]
Signs and symptoms
The size of the swelling is variable, but it is soft[4] and can occur on one side or both sides.[1] It is typically non tender,[4] although sometimes there may be pain.[1] It usually resolves over minutes to hours, however occasionally this may take days.[1] The condition can be transient or recurrent.[5]
Causes
The condition is caused by raised air pressure in the mouth.
[1]
Diagnosis and management
Pneumoparotitis is often misdiagnosed and incorrectly managed.[5] The diagnosis is based mainly on the history.[1]Crepitus may be elicited on palpation of the parotid swelling,[1] and massaging the gland may give rise to frothy saliva or air bubbles from the parotid papilla.[1] Further investigations are not typically required, however sialography, ultrasound and computed tomography may all show air in the parotid gland and duct.[1]
Management is simply by avoidance of the activity causing raised intraoral pressure which is triggering this rare condition.[1]
The condition is rare.[5] It is more likely to occur in persons who regularly have raised pressure in the mouth, for example wind instrument players,[6] and balloon[1] and glass-blowers.[7] Cases have also been reported with bicycle tyre inflation,[1] whistling,[1]nose blowing,[1] cough[1] and valsalva manoeuvre to clear the ears.[1] It can be an iatrogenic effect of dental treatment,[1]spirometry,[1] and positive pressure ventilation.[2] Apart from these factors, the condition mainly occurs in adolescents, often self-inflicted due to psychological issues.[7][8]
^Kreuter, M; Kreuter, C; Herth, F (February 2008). "[Pneumological aspects of wind instrument performance--physiological, pathophysiological and therapeutic considerations]". Pneumologie (Stuttgart, Germany). 62 (2): 83–7. doi:10.1055/s-2007-996164. PMID18075966.
^ abFerlito, A; Andretta, M; Baldan, M; Candiani, F (June 1992). "Non-occupational recurrent bilateral pneumoparotitis in an adolescent". The Journal of Laryngology and Otology. 106 (6): 558–60. doi:10.1017/s0022215100120146. PMID1624898.
^Markowitz-Spence, L; Brodsky, L; Seidell, G; Stanievich, JF (December 1987). "Self-induced pneumoparotitis in an adolescent. Report of a case and review of the literature". International Journal of Pediatric Otorhinolaryngology. 14 (2–3): 113–21. doi:10.1016/0165-5876(87)90021-8. PMID3325441.