Journal of Maxillofacial and Oral Surgery

, Volume 17, Issue 2, pp 117–121 | Cite as

Bilateral Parotid Sialadenosis Associated with Long-Standing Bulimia: A Case Report and Literature Review

  • Blas Garcia Garcia
  • Alicia Dean Ferrer
  • Nelida Diaz Jimenez
  • Francisco Jesus Alamillos Granados
Review Paper



Bulimia is a common cause of sialadenosis. This paper presents a case of bilateral parotid sialadenosis associated with long-standing bulimia, and reviews the relevant literature and current treatment options.

Methods and Results

A 32-year-old woman had severe bilateral parotid sialomegaly for the last 6 years, which had occurred secondary to bulimia nervosa, which she had since 14 years. Treatment with pilocarpine was unsuccessful, so she underwent bilateral conservative parotidectomy. This procedure not only improved the aesthetic appearance of the patient but also improved her social and work life and overall quality of life.


Sialomegaly secondary to bulimia results in a major alteration of the aesthetics of a patient’s face. Conservative measures are not enough in many cases, and parotidectomy may be the only viable option, as it can also significantly improve adherence to psychiatric treatment for bulimia, in addition to correcting the facial aesthetics.


Bulimia Parotid gland Sialadenosis Parotidectomy Eating disorder 


Compliance with Ethical Standards

Conflicts of interest

The researchers declare no conflicts of interest.


  1. 1.
    Donath K (1976) Sialadenosis of the parotid gland. Ultrastructural, clinical and experimental findings in disturbances of secretion. Veroff Pathol 103:1–122Google Scholar
  2. 2.
    Watt J (1977) Bening parotid swelling: a review. Proc R Soc Med 70:483–486PubMedPubMedCentralGoogle Scholar
  3. 3.
    Devlin MJ, Steinglass JE (2010) Eating disorders. In: Cutler JL, Marcus ER (eds) Psychiatry, 2nd edn. Oxford University Press, New YorkGoogle Scholar
  4. 4.
    Lavender S (1969) Vomiting and parotid enlargement. Lancet 1:426CrossRefPubMedGoogle Scholar
  5. 5.
    Kessler RC, Berglund PA, Chiu WT et al (2013) The prevalence and correlates of binge eating disorder in the WHO World Mental Health Surveys. Biol Psychiatry 73:904–914CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ogren FP, Huerter JV, Pearson PH, Antonson CW, Moore GF (1987) Transient salivary gland hypertrophy in bulimics. Laryngoscope 97:951–953CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell JE, Hatsukami D, Eckert ED, Pyle RL (1985) Characteristics of 275 patients with bulimia. Am J Psychiatry 142:482–485CrossRefPubMedGoogle Scholar
  8. 8.
    Mandel L, Kaynar A (1992) Bulimia and parotid swelling: a review and case report. J Oral Maxillofac Surg 50:1122–1125CrossRefPubMedGoogle Scholar
  9. 9.
    Price C, Schmidt MA, Adam EJ, Lacey H (2008) Parotid gland enlargement in eating disorders: an insensitive sign? Eat Weight Disord 13:79–83CrossRefGoogle Scholar
  10. 10.
    Nassour DN, Patel SV, Kosseifi SG, Jordan RM, Peiris AN (2007) Marked bilateral parotid enlargement in metabolic syndrome: a case report and review of the literature. Tenn Med 100:39–41Google Scholar
  11. 11.
    Wilson T, Price T (2003) Revisiting a controversial surgical technique in the treatment of bulimic parotid hypertrophy. Am J Otolaryngol 24:85–88CrossRefPubMedGoogle Scholar
  12. 12.
    Herrlinger P, Gundlach P (2001) Hypertrophy of the salivary glands in bulimia. HNO 49:557–559CrossRefPubMedGoogle Scholar
  13. 13.
    Monteleone P, Santonastaso P, Pannuto M, Favaro A, Caregaro L, Castaldo E, Zanetti T, Maj M (2005) Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 134:267–273CrossRefPubMedGoogle Scholar
  14. 14.
    Wolfe BE, Jimerson DC, Smith A, Keel PK (2011) Serum amylase in bulimia nervosa and purging disorder: differentiating the association with binge eating versus purging behavior. Physiol Behav 104:684–686CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Colevas AD (1998) Re: “Sialadenosis: a presenting sign in bulimia”. Head Neck 20:758–762 (Head Neck. 1999;2:582) CrossRefGoogle Scholar
  16. 16.
    Mehler PS, Wallace JA (1993) Sialadenosis in bulimia. A new treatment. Arch Otolaryngol Head Neck Surg 119:787–788CrossRefPubMedGoogle Scholar
  17. 17.
    Hay PJ, Claudino AM (2015) Bulimia nervosa: online interventions. BMJ Clin Evid 1:1009Google Scholar
  18. 18.
    Berke GS, Calcaterra TC (1985) Parotid hypertrophy with bulimia: a report of surgical management. Laryngoscope 95:597–598CrossRefPubMedGoogle Scholar
  19. 19.
    Rauch S, Herzog D (1987) Parotidectomy for bulimia: a dissenting view. Am J Otolaryngol 8:376–380CrossRefPubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2016

Authors and Affiliations

  • Blas Garcia Garcia
    • 1
    • 3
  • Alicia Dean Ferrer
    • 1
  • Nelida Diaz Jimenez
    • 2
  • Francisco Jesus Alamillos Granados
    • 1
  1. 1.Department of Oral, Maxillofacial Surgery, Odonto-Stomatology, Faculty of MedicineUniversity Hospital Reina SofiaCórdobaSpain
  2. 2.Department of General SurgeryUniversity Hospital Reina SofiaCórdobaSpain
  3. 3.CórdobaSpain

Personalised recommendations