From the Guidelines
Parotitis treatment is primarily focused on managing symptoms, as it is often caused by a viral infection, such as mumps, and typically resolves on its own.
Treatment Overview
- The treatment approach may involve supportive care, such as pain management and hydration, to alleviate symptoms like swelling and discomfort in the parotid gland.
- In some cases, antibiotics may be prescribed if a bacterial infection is suspected or confirmed.
- For patients with parotitis caused by an autoimmune disorder, such as GPA, immunosuppressive therapy may be recommended to manage the underlying condition 1.
Specific Considerations
- For mumps-related parotitis, vaccination with the MMR vaccine is the most effective way to prevent the infection 1.
- In cases where parotitis is caused by a mass lesion, such as an orbital pseudotumor or a mass in the parotid gland, immunosuppressive therapy is usually the initial treatment of choice 1.
- Surgical intervention may be considered in certain situations, such as when there is an urgent need for decompression or when other treatments have failed.
General Management
- Patients with parotitis should be encouraged to stay hydrated, apply warm compresses to the affected area, and manage their pain with over-the-counter medications as needed.
- It is essential to monitor for potential complications, such as dehydration or secondary bacterial infections, and seek medical attention if symptoms worsen or persist 1.
From the Research
Treatment Options for Parotitis
The treatment for parotitis can vary depending on the severity and cause of the condition. Some of the treatment options include:
- Conservative medical management, which may involve maintaining hydration and administering parenteral antimicrobial therapy 2
- Surgical interventions, such as parotidectomy, which can be considered for chronic parotitis that is unresponsive to conservative therapy 3, 4, 5
- Sialendoscopy, which can be used to diagnose and treat chronic parotitis 5
- Maintenance of good oral hygiene, adequate hydration, and early and proper therapy of bacterial infection of the oropharynx to reduce the occurrence of suppurative parotitis 2
Surgical Treatment
Surgical treatment, such as parotidectomy, can be an effective option for chronic parotitis. The study by 4 found that parotidectomy was successful in 87% of cases, with 95% of patients being content with the result. However, the study also noted that there is no evidence of a distinct difference between superficial and near-total parotidectomy regarding efficiency, facial nerve palsy, or Frey syndrome.
Management of Chronic Parotitis
The management of chronic parotitis can be challenging, and controversy exists regarding the timing and method of surgical intervention 5. A comprehensive patient-centered approach can be used to treat parotitis, taking into account the patient's overlapping clinical conditions, lifestyle, and work factors 6.
Antimicrobial Therapy
The choice of antimicrobial therapy depends on the etiologic agent causing the parotitis. The study by 2 found that the most common pathogens associated with acute bacterial parotitis are Staphylococcus aureus and anaerobic bacteria, and that gram-negative organisms are often seen in hospitalized patients. The study recommends maintenance of hydration and administration of parenteral antimicrobial therapy, with the choice of antimicrobial depending on the etiologic agent.