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Die chronisch rezidivierende Parotitis

Chronic recurrent parotitis

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Zusammenfassung

Die chronisch rezidivierende Parotitis ist eine nicht obstruktive Erkrankung mit episodischen, meist schmerzhaften Schwellungen. Sie lässt sich in eine juvenile und eine adulte Form trennen, ohne dass die eigentliche Ätiologie der Erkrankung sicher geklärt ist. Diskutiert werden bei der juvenilen Form neben genetischen und angeborenen Faktoren auch die Bedeutung bakterieller Infektionen, die eine geringgradige Entzündung aufrechterhalten. Selten kann die Drüse im Verlauf komplett lymphatisch transformieren. Die juvenile chronisch rezidivierende Parotitis hat in 90% aller Fälle einen selbstlimitierenden Verlauf. Die Diagnose ergibt sich primär aus der Anamnese und den klinischen Symptomen. Als Bildgebung der Wahl gilt die hochauflösende Sonographie. Die Sialendoskopie zeigt typische Befunde bei der juvenilen Form, Gangstrikturen oder Stenosen des distalen Gangsystems bei der adulten Form. Die Therapie der Wahl ist neben der Gabe von Penicillin die Drüsenmassage und Speichelanregung. Bei schwierigen Verläufen ist die Sialendoskopie mit Spülung der Speichelgänge und Instillation von Kortison indiziert. Die totale Parotidektomie ist Ultima ratio und wird selten benötigt.

Abstract

Chronic recurrent parotitis is a non-obstructive disease with episodes of mostly painful swelling of the gland. It is categorized into a juvenile and an adult form, even without clear information on its actual origin. As to the etiology of the juvenile form, genetic factors and duct malformations as well as bacterial infections are discussed. Very rarely a complete lymphatic transformation of the gland might take place. Juvenile chronic recurrent parotitis is self-limiting in about 90% of all cases, as patients grow up. The diagnosis is based on patient history and clinical findings. Sonography is the imaging method of choice. Sialendoscopy shows a typical whitish pattern of the ducts in juvenile disease. Strictures or stenoses are typical for the adult form. The therapy of choice is gland massage and sialagogues, in addition to the administration of antibiotics. In more severe cases sialendoscopy together with rinsing of the ducts and instillation of cortisone are indicated. Total parotidectomy remains the last choice and is rarely necessary.

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Literatur

  1. Seifert G (1997) Aetiological and histological classification of sialadenitis. Pathologica 89:7–17

    CAS  PubMed  Google Scholar 

  2. Ussmuller J, Donath K (1999) Clinical, histopathologic and immunohistochemical studies of chronic sialectatic parotitis in childhood and adolescence. Klin Padiatr 211:165–171

    Article  CAS  PubMed  Google Scholar 

  3. Galili D, Marmary Y (1986) Juvenile recurrent parotitis: clinicoradiologic follow-up study and the beneficial effect of sialography. Oral Surg Oral Med Oral Pathol 61:550–556

    Article  CAS  PubMed  Google Scholar 

  4. Ericson S, Zetterlund B, Ohman J (1991) Recurrent parotitis and sialectasis in childhood. Clinical, radiologic, immunologic, bacteriologic, and histologic study. Ann Otol Rhinol 100:527–535

    CAS  PubMed  Google Scholar 

  5. Bailey H (1945) Congenital parotid sialectasis. J Int Coll Surg 8:109–114

    Google Scholar 

  6. Maynard JD (1965) Recurrent parotid enlargement. Br J Surg 52:784–789

    Article  CAS  PubMed  Google Scholar 

  7. Hemenway WG (1971) Chronic punctate parotitis. Laryngoscope 81:485–509

    Article  CAS  PubMed  Google Scholar 

  8. Zou ZJ, Wang SL, Zhu JR et al (1990) Recurrent parotitis in children. A report of 102 cases. Chin Med J (Engl) 103:576–582

    Google Scholar 

  9. Konno A, Ito E (1979) A study on the pathogenesis of recurrent parotitis in childhood. Ann Otol Rhinol Laryngol 88:1–20

    CAS  Google Scholar 

  10. Wittekindt C, Jungehulsing M, Fischbach R, Landwehr P (2000) Chronic recurrent parotitis in childhood in monozygotic twins. Magnetic resonance sialography. HNO 48:221–225

    Article  CAS  PubMed  Google Scholar 

  11. Reid E, Douglas F, Crow Y et al (1998) Autosomal dominant juvenile recurrent parotitis. J Med Genet 35:417–419

    Article  CAS  PubMed  Google Scholar 

  12. Morales-Bozo I, Landaeta M, Urzua-Orellana B, Retamales P (2008) Association between the occurrence of matrix metalloproteinases 2 and 9 in parotid saliva with the degree of parotid gland damage in juvenile recurrent parotitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:377–383

    Article  PubMed  Google Scholar 

  13. Wu AJ, Lafrenie RM, Park C et al (1997) Modulation of MMP-2 (gelatinase A) and MMP-9 (gelatinase B) by interferon-gamma in a human salivary gland cell line. J Cell Physiol 71:117–124

    Article  Google Scholar 

  14. Bowling DM, Ferry G, Rauch SD, Goodman ML (1994) Intraductal tetracycline therapy for the treatment of chronic recurrent parotitis. Ear Nose Throat J 73:262–274

    CAS  PubMed  Google Scholar 

  15. Andrade RE, Hagen KA, Manivel JC (1988) Distribution and immunophenotype of the inflammatory cell population in the benign lymphoepithelial lesion (Mikulicz’s disease). Hum Pathol 19:932–941

    Article  CAS  PubMed  Google Scholar 

  16. Marsman WA, Sukhai RN (1999) Recurrent parotitis and isolated IgG3 subclass deficiency. Eur J Pediatr 158:684

    Article  CAS  PubMed  Google Scholar 

  17. Ericson S, Sjoback I (1996) Salivary factors in children with recurrent parotitis. Part 2: Protein, albumin, amylase, IgA, lactoferrin lysozyme and kallikrein concentrations. Swed Dent J 20:199–207

    CAS  PubMed  Google Scholar 

  18. Baurmash HD (2004) Chronic recurrent parotitis: a closer look at its origin, diagnosis, and management. J Oral Maxillofac Surg 62:1010–1018

    Article  PubMed  Google Scholar 

  19. Mandel ID, Baurmash H (1980) Sialochemistry in chronic recurrent parotitis: electrolytes and glucose. J Oral Pathol 9:92–98

    Article  CAS  PubMed  Google Scholar 

  20. Mandel L, Witek EL (2001) Chronic parotitis: diagnosis and treatment. J Am Dent Assoc 132:1707–1711; quiz 1727

    CAS  PubMed  Google Scholar 

  21. Nahlieli O, Shacham R, Shlesinger M, Eliav E (2004) Juvenile recurrent parotitis: a new method of diagnosis and treatment. Pediatrics 114:9–12

    Article  PubMed  Google Scholar 

  22. Sitheeque M, Sivachandran Y, Varathan V et al (2007) Juvenile recurrent parotitis: clinical, sialographic and ultrasonographic features. Int J Paediatr Dent 17:98–104

    Article  PubMed  Google Scholar 

  23. Shimizu M, Ussmuller J, Donath K et al (1998) Sonographic analysis of recurrent parotitis in children: a comparative study with sialographic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:606–615

    Article  CAS  PubMed  Google Scholar 

  24. Iro H, Uttenweiler V, Zenk J (2000) Kopf-Hals-Sonographie. Eine Anleitung zur praxisbezogenen Ultraschalluntersuchung. Springer, Berlin Heidelberg New York

  25. Huisman TA, Holzmann D, Nadal D (2001) MRI of chronic recurrent parotitis in childhood. J Comput Assist Tomogr 25:269–273

    Article  CAS  PubMed  Google Scholar 

  26. Watkin GT, Hobsley M (1986) Natural history of patients with recurrent parotitis and punctate sialectasis. Br J Surg 73:745–748

    Article  CAS  PubMed  Google Scholar 

  27. Geterud A, Lindvall AM, Nylen O (1988) Follow-up study of recurrent parotitis in children. Ann Otol Rhinol Laryngol 97:341–346

    CAS  PubMed  Google Scholar 

  28. Katzen M, Duplessis DJ (1964) Recurrent parotitis in children. S Afr Med J 38:122–128

    CAS  PubMed  Google Scholar 

  29. Glasenapp GB, Schmidt W, Kessler L, Otto HJ (1970) Treatment of chronic recurrent parotitis by roentgen irradiation under scintigraphic control. Z Laryngol Rhinol Otol 49:520–525

    CAS  PubMed  Google Scholar 

  30. Carlson RG, Glas WW (1963) Acute suppurative parotitis. Twenty-eight cases at a county hospital. Arch Surg 86:659–663

    CAS  PubMed  Google Scholar 

  31. Eddey HH, Mc KG (1953) Surgical treatment of recurrent parotitis. Med J Aust 2:715–717

    CAS  PubMed  Google Scholar 

  32. Beahrs OH, Devine KD, Woolner LB (1961) Parotidectomy in the treatment of chronic sialadenitis. Am J Surg 02:760–764

    Article  Google Scholar 

  33. Diamant H, Enfors B (1965) Treatment of chronic recurrent parotitis. Laryngoscope 75:153–160

    Article  CAS  PubMed  Google Scholar 

  34. Rettinger G, Stolte M, Baumler C (1981) Elimination of major salivary glands by temporary medicamentous occlusion of the excretory ducts. HNO 29:294–299

    CAS  PubMed  Google Scholar 

  35. Daud AS, Pahor AL (1995) Tympanic neurectomy in the management of parotid sialectasis. J Laryngol Otol 109:1155–1158

    Article  CAS  PubMed  Google Scholar 

  36. Leerdam CM, Martin HC, Isaacs D (2005) Recurrent parotitis of childhood. J Paediatr Child Health 41:631–634

    Article  CAS  PubMed  Google Scholar 

  37. Maier H, Adler D, Lenarz T, Muller-Esterl W (1985) New concepts in the treatment of chronic recurrent parotitis. Arch Otorhinolaryngol 242:321–328

    Article  CAS  PubMed  Google Scholar 

  38. Rubaltelli L, Sponga T, Candiani F et al (1987) Infantile recurrent sialectatic parotitis: the role of sonography and sialography in diagnosis and follow-up. Br J Radiol 60:1211–1214

    Article  CAS  PubMed  Google Scholar 

  39. Shacham R, Droma EB, London D et al (2009) Long-term experience with endoscopic diagnosis and treatment of juvenile recurrent parotitis. J Oral Maxillofac Surg 67:162–167

    Article  PubMed  Google Scholar 

  40. Quenin S, Plouin-Gaudon I, Marchal F et al (2008) Juvenile recurrent parotitis: sialendoscopic approach. Arch Otolaryngol Head Neck Surg 134:715–719

    Article  PubMed  Google Scholar 

  41. Koch M, Zenk J, Iro H (2008) Diagnostic and interventional sialoscopy in obstructive diseases of the salivary glands. HNO 56:139–144

    Article  CAS  PubMed  Google Scholar 

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  1. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland

    J. Zenk, M. Koch, N. Klintworth & H. Iro

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  1. J. Zenk
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  2. M. Koch
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  3. N. Klintworth
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  4. H. Iro
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Correspondence to J. Zenk.

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Zenk, J., Koch, M., Klintworth, N. et al. Die chronisch rezidivierende Parotitis. HNO 58, 237–243 (2010). https://doi.org/10.1007/s00106-009-2079-9

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