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Right arrow Dentistry & Otolaryngology
PEDIATRICS Vol. 114 No. 1 July 2004, pp. 9-12

Juvenile Recurrent Parotitis: A New Method of Diagnosis and Treatment

Oded Nahlieli, DMD*, Rachel Shacham, DMD{ddagger}, Menahem Shlesinger, MD§ and Eli Eliav, DMD, MSC||

* Department of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon, affiliated with the Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
{ddagger} Department of Oral and Maxillofacial Surgery Barzilai Medical Center, Ashkelon
§ Pediatric Department, Barzilai Medical Center, Ashkelon, Israel
|| Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Barzilai Medical Center, Ashkelon, Israel

Objective. Juvenile recurrent parotitis (JRP) is a nonobstructive, nonsuppurative parotid inflammation in young children. Causative factors, such as local autoimmune manifestation, allergy, infection, and genetic inheritance, have been suggested, but none of them has been proved to date. Until now, treatment of JRP was divided into conservative observation and antibiotic treatment, and no preventive therapy was available.

Methods. Twenty-six cases symptomatic JRP in children were diagnosed and treated with a combined endoscopic approach. Sialography and sialoendoscopy were performed bilaterally in all children. The treatment modality was composed of lavage, ductal dilation, and hydrocortisone injection.

Results. Sialography showed multiple sialectasis in the affected gland and in the contralateral one as well. Dilations and strictures were noticed in the main duct, and kinks could be identified in 31% of the glands. The main endoscopic finding was a white appearance of the ductal layer without the healthy blood vessel coverage. Recurrence of the symptoms occurred in only 2 (8%) children.

Conclusions. The endoscopic technique provides the possibility of a correct diagnosis and treatment. In this article, we present a new treatment modality of irrigation and dilation under direct vision by endoscopically guided miniature surgical instruments.

Key Words: juvenile parotitis • sialoendoscopy • sialography • sialectasis • therapeutic technique

Abbreviations: JRP, juvenile recurrent parotitis

Received for publication Aug 5, 2003; Accepted Dec 2, 2003.




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