Juvenile recurrent parotitis: a new method of diagnosis and treatment.
OBJECTIVE
Juvenile recurrent parotitis (JRP) is a nonobstructive, nonsuppurative parotid inflammation in young children. Causative factors, such as local autoimmune manifestation, allergy, infection, and genetic inheritance, have been suggested, but none of them has been proved to date. Until now, treatment of JRP was divided into conservative observation and antibiotic treatment, and no preventive therapy was available.


METHODS
Twenty-six cases symptomatic JRP in children were diagnosed and treated with a combined endoscopic approach. Sialography and sialoendoscopy were performed bilaterally in all children. The treatment modality was composed of lavage, ductal dilation, and hydrocortisone injection.


RESULTS
Sialography showed multiple sialectasis in the affected gland and in the contralateral one as well. Dilations and strictures were noticed in the main duct, and kinks could be identified in 31% of the glands. The main endoscopic finding was a white appearance of the ductal layer without the healthy blood vessel coverage. Recurrence of the symptoms occurred in only 2 (8%) children.


CONCLUSIONS
The endoscopic technique provides the possibility of a correct diagnosis and treatment. In this article, we present a new treatment modality of irrigation and dilation under direct vision by endoscopically guided miniature surgical instruments.
Nahlieli
Oded
O
Department of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon, Israel. nahlieli@yahoo.com
Shacham
Rachel
R
Shlesinger
Menahem
M
Eliav
Eli
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D010309:Parotitis / Q000175:diagnosis / Q000628:therapy*; D011859:Radiography; D018987:Salivary Ducts / Q000473:pathology / Q000601:surgery; D055502:Secondary Prevention; D007507:Therapeutic Irrigation; D014463:Ultrasonography