title: Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness.
abstract: OBJECTIVE
  Juvenile recurrent parotitis (JRP) is characterized by recurrent painful swelling of the parotid gland that occurs in the pediatric population. Sialendoscopy with and without ductal corticosteroid infusion (DCI) has been found to be effective in the treatment of JRP and autoimmune parotitis.
  
  
  OBJECTIVE
  To determine the utility of instrumentation vs pharmacotherapy alone for juvenile recurrent parotitis.
  
  
  METHODS
  A retrospective medical record review of pediatric patients undergoing DCI without sialendoscopy at a tertiary pediatric hospital was conducted. The medical records were reviewed to determine the frequency of parotitis events before and after treatment. A multiquestion telephone survey of patients and their parents who underwent the procedure was then conducted to determine patient satisfaction.
  
  
  METHODS
  Ductal corticosteroid infusion with hydrocortisone through catheter inserted in the parotid duct.
  
  
  METHODS
  Frequency of symptoms before and after treatment and parental satisfaction with the treatment.
  
  
  RESULTS
  Twelve patients with a mean age of 6.7 years were identified. The mean duration and frequency of symptoms before the procedure were 22 months and every 2 months, respectively. Five patients had a recurrence, on average 4 months after the procedure. Four patients underwent repeated surgical procedures. All had a longer duration between episodes compared with before DCI. Eight parents participated in the survey on satisfaction with the procedure, and 75% reported improvement in their child's life postprocedure.
  
  
  CONCLUSIONS
  Current literature shows sialendoscopy with corticosteroid application is successful in treating JRP, but it is unclear whether corticosteroid application alone would treat JRP equally. This study shows that DCI alone has similar results as sialendoscopy with corticosteroid application, indicating that it is the corticosteroid application and not the sialendoscopy causing improvement in symptoms. Because JRP must be differentiated from sialolithiasis, we recommend ultrasonography of the involved parotid(s) prior to using DCI alone to ensure no stone is present. Sialendoscopy should be reserved to rule out other parotid ductal pathologic conditions.
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora2Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Brianne Barnett
authors.initials: BB
authors.lastname: Roby
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora2Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Jameson
authors.initials: J
authors.lastname: Mattingly
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora2Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Jensen
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora.
authors.forename: Dexiang
authors.initials: D
authors.lastname: Gao
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora2Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado.
authors.forename: Kenny H
authors.initials: KH
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D010290:Parents; D010309:Parotitis / Q000628:therapy*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D018987:Salivary Ducts
chemical_list: D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone