Zenk J, Koch M, Klintworth N, Iro H
Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen.
HNO. 2010 Mar;58(3):237-43. doi: 10.1007/s00106-009-2079-9.
Chronic recurrent parotitis is a non-obstructive disease with episodes of mostly painful swelling of the gland. It is categorized into a juvenile and an adult form, even without clear information on its actual origin. As to the etiology of the juvenile form, genetic factors and duct malformations as well as bacterial infections are discussed. Very rarely a complete lymphatic transformation of the gland might take place. Juvenile chronic recurrent parotitis is self-limiting in about 90% of all cases, as patients grow up. The diagnosis is based on patient history and clinical findings. Sonography is the imaging method of choice. Sialendoscopy shows a typical whitish pattern of the ducts in juvenile disease. Strictures or stenoses are typical for the adult form. The therapy of choice is gland massage and sialagogues, in addition to the administration of antibiotics. In more severe cases sialendoscopy together with rinsing of the ducts and instillation of cortisone are indicated. Total parotidectomy remains the last choice and is rarely necessary.
慢性复发性腮腺炎是一种非阻塞性疾病,主要表现为腮腺反复肿痛。它分为青少年型和成人型,但其实际病因尚不明确。关于青少年型的病因,有遗传因素、导管畸形以及细菌感染等说法。极少数情况下,腮腺可能会发生完全性淋巴化生。约90%的青少年慢性复发性腮腺炎患者随着年龄增长会自愈。诊断基于患者病史和临床表现。超声检查是首选的影像学检查方法。唾液腺内镜检查显示青少年型疾病中导管典型的白色外观。狭窄或缩窄是成人型的典型表现。除使用抗生素外,首选治疗方法是腮腺按摩和催涎剂。在更严重的病例中,需要进行唾液腺内镜检查,并冲洗导管和注入皮质类固醇。腮腺全切术仍是最后的选择,且很少需要。