European Archives of Oto-Rhino-Laryngology

, Volume 265, Issue 9, pp 1095–1102 | Cite as

Salivary gland biometry in female patients with eating disorders

  • Alessandro BozzatoEmail author
  • Pascal Burger
  • Johannes Zenk
  • Wolfgang Uter
  • Heinrich Iro
Head and Neck


High-resolution greyscale ultrasound is a generally accepted diagnostic tool for salivary gland enlargement, although no standard biometrical data for the sizes of unaffected parotid and submandibular glands exist. A lot of case reports describe non-inflammatory swelling of salivary glands as symptoms of eating disorders like anorexia nervosa or bulimia nervosa. They might be the only visible sign for the disease. With our prospective study we tried to quantify and compare biometrically the salivary gland in eating disordered patients, obese and normal-weight, healthy controls. A total of 70 females between 16 and 40 years of age were included of which 25 were healthy controls. All subjects underwent three-dimensional high resolution B-scan sonography of the parotid and submandibular gland. Gland volumes were calculated and a multiple regression analysis was done to investigate the influence of an eating disorder on salivary gland size. A significant difference in the size of the parotid glands was seen between our three study groups of adipose and eating disordered patients and healthy, normal-weight controls. The parotid gland volumes were seen in the subgroup bulimia nervosa (BN), (parotid volume = 63,708 mm3) where the mean value was more than twice as high as in the control group (31,059 mm3). By using body mass index and group characteristic the parotid gland volume as the dependent variable could be estimated with an r 2 of 0.327 in multiple regression analysis. Only the parotid glands were significantly enlarged, while the submandibular glands show no signs of enlargement. Eating disorders influence size of parotid glands, still the factors and the pathogenesis leading to this enlargement seem to be different in adiposity on the one and different types of eating disorders on the other hand. Standard gland volumes could be established, comparable to former initial reports. Submandibular gland remains unaffected by these alterations. We could show that high-resolution ultrasound assessment of parotid gland volume adds a complementary quantitative parameter of organ affection in eating disorders (anorexia/bulimia nervosa).


Salivary glands Ultrasound Eating disorders Biometry Sonography 


  1. 1.
    Du Plessis DJ (1956) Parotid enlargement in malnutrition. S Afr Med J 30(30):700–703PubMedGoogle Scholar
  2. 2.
    Herrlinger P, Gundlach P (2001) Vergrößerung der Speicheldrüsen bei Bulimie. HNO 49(7):557–559PubMedCrossRefGoogle Scholar
  3. 3.
    Metzger ED, Levine JM, McArdle CR, Wolfe BE, Jimerson DC (1999) Salivary gland enlargement and elevated serum amylase in bulimia nervosa. Biol Psychiatry 45:1520–1522PubMedCrossRefGoogle Scholar
  4. 4.
    Mitchell JE, Hatsukami D, Eckert ED, Pyle RL (1985) Characteristics of 275 patients with bulimia. Am J Psychiatry 142:482–485PubMedGoogle Scholar
  5. 5.
    Sharp W, Freeman CPL (1993) The medical complications of anorexia nervosa. Br J Psychiatry 162:452–462PubMedCrossRefGoogle Scholar
  6. 6.
    Lavender S (1969) Vomiting and parotid enlargement. Lancet 1:426PubMedCrossRefGoogle Scholar
  7. 7.
    Holtkamp K, Herpertz-Dahlmann B (2005) Anorexia und Bulimia nervosa im Kindes- und Jugendalter. Deutsches Ärzteblatt 102(1–2):A50–A58Google Scholar
  8. 8.
    Heo MS, Lee SC, Lee SS, Choi MS, Choi SC, Park TW (2001) Quantitative analysis of normal major salivary glands using computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92(2):240–244PubMedCrossRefGoogle Scholar
  9. 9.
    Fairburn CG, Brownell KD (eds) (2002) Auflage. In: Eating disorders and obesity—a comprehensive handbook, vol 2, 2nd edn. The Guilford Press, New York, pp 155–170, 267–285, 417–427, 561–567Google Scholar
  10. 10.
    Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361:407–416PubMedCrossRefGoogle Scholar
  11. 11.
    Dost P, Kaiser S (1997) Ultrasonographic biometry in salivary glands. Ultrasound Med Biol 23(9):1299–1303PubMedCrossRefGoogle Scholar
  12. 12.
    Probst R, Grevers G, Iro H (2004) Hals-Nasen-Ohren-Heilkunde. In: korrigierte und aktualisierte Auflage, vol 2. Georg Thieme Verlag, Stuttgart, pp 134–135, 142–143Google Scholar
  13. 13.
    Vavrina J, Müller W, Gebbers J-O (1994) Enlargement of salivary glands in bulimia. J Laryngol Otol 108:516–518PubMedCrossRefGoogle Scholar
  14. 14.
    Ogren FP, Huerter JV, Pearson PH, Antonson CW, Moore GF (1987) Transient salivary gland hypertrophy in bulimics. Laryngoscope 97:951–953PubMedCrossRefGoogle Scholar
  15. 15.
    Coleman H, Altini M, Nayler S, Richards A (1999) Sialadenosis: a presenting sign in bulimia. Head Neck 20(8):758–762CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Alessandro Bozzato
    • 1
    • 4
    Email author
  • Pascal Burger
    • 2
  • Johannes Zenk
    • 1
  • Wolfgang Uter
    • 3
  • Heinrich Iro
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryFriedrich-Alexander-UniversityErlangen-NurembergGermany
  2. 2.Department of PsychiatryFriedrich-Alexander-UniversityErlangen-NurembergGermany
  3. 3.Institute for Medical Informatics, Biometry and EpidemiologyFriedrich-Alexander-UniversityErlangen-NurembergGermany
  4. 4.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Erlangen-Nuremberg, Medical SchoolErlangenGermany

Personalised recommendations