From the Guidelines
Sialadenitis is not common in children, with the incidence significantly reduced due to widespread vaccination against mumps, a primary cause of viral sialadenitis in this age group. The condition, characterized by inflammation of the salivary glands, can occur in children but is relatively rare compared to adults. According to the study 1, mumps was a common childhood illness before the introduction of the vaccine, with approximately 186,000 cases reported annually in the United States. However, after the implementation of vaccination policies, reports of mumps cases declined by 99%, indicating a substantial reduction in the incidence of viral sialadenitis in children.
Key Points
- The introduction of the mumps vaccine has significantly reduced the incidence of sialadenitis in children 1.
- Mumps outbreaks can still occur, particularly in crowded environments or among unvaccinated or undervaccinated populations, as seen in the 2006 outbreak in the United States 1.
- Bacterial sialadenitis, though less common than viral, can occur in children and typically involves the parotid gland, with treatment including antibiotics such as amoxicillin-clavulanate.
- The rarity of sialadenitis in children is attributed to good salivary flow and fewer predisposing factors compared to adults.
Considerations for Clinical Practice
When encountering a case of sialadenitis in a child, it is essential to consider the vaccination history, as well as potential predisposing factors such as dehydration or systemic illnesses. Treatment should be tailored to the cause, with viral cases often managed supportively and bacterial cases requiring antibiotic therapy. Given the reduced incidence of mumps due to vaccination, as highlighted in the study 1, the approach to sialadenitis in children should prioritize diagnosis and appropriate management based on the underlying cause.
From the Research
Prevalence of Sialadenitis in Children
- Sialadenitis in the pediatric population accounts for up to 10% of all salivary gland disease 2
- Diseases of the salivary glands are rare among infants and children 3
- Salivary disease in childhood is uncommon 4
Causes of Sialadenitis in Children
- Viral parotitis and juvenile recurrent parotitis are the two most common causes of sialadenitis in children 2
- Juvenile recurrent parotitis is the most common cause of sialadenitis in children 5
- Sialolithiasis, or salivary stones, are a less common cause of sialadenitis in children 5
- Inflammation, either bacterial or viral, is the most common disease 4
Diagnosis and Treatment of Sialadenitis in Children
- Sialendoscopy has emerged as the leading diagnostic technique and intervention for pediatric sialadenitis 2
- Sialendoscopy is a safe and effective gland-preserving treatment of pediatric sialadenitis 2, 5, 6
- Sialendoscopy and salivary duct irrigation have been shown to improve frequency and severity of sialadenitis episodes in patients with juvenile recurrent parotitis 5
- Minimally invasive approaches with sialendoscopy have improved the ability to preserve salivary glands in patients with recurrent sialadenitis 5