Patra Sounak, Das Sauradeep, Tamuli Prachurya, Chakraborty Suvamoy
Department of ENT, NEIGRIHMS, Shillong, 793018 India.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):4054-4056. doi: 10.1007/s12070-023-04030-7. Epub 2023 Jul 6.
Acute parotitis in children is a common occurrence with predisposing factors including ductal dysfunction, poor oral hygiene or dental infections, immunosuppression, dehydration, or a pre-existing Warthin's tumour. Bacterial or viral infections of the intra-parotid and peri-parotid lymph nodes or the parotid gland parenchyma results in inflammatory followed by suppurative changes which leads to formation of parotid abscess. Surgical drainage is necessary in parotid abscesses not responding to conservative management. Surgical intervention is invasive and has associated risks of injury to the facial nerve and poor cosmetic outcome. We present a case of parotid abscess in a 9-year-old female child which required surgical drainage. In literature, parotid gland abscess arising from a preceeding dental infection in paediatric age group is an uncommon occurence and limited number of cases have been documented. The first line of imaging is ultrasonographic examination of the parotid gland which adds on to the clinical examination. In combination with color doppler, sonography is of immense assistance for diagnosis and evaluation of therapeutic efficacy and also helps guide aspiration or incision and drainage.
儿童急性腮腺炎很常见,诱发因素包括导管功能障碍、口腔卫生差或牙齿感染、免疫抑制、脱水或既往存在的沃辛瘤。腮腺内及腮腺周围淋巴结或腮腺实质的细菌或病毒感染会导致炎症,随后出现化脓性改变,进而形成腮腺脓肿。对于对保守治疗无反应的腮腺脓肿,手术引流是必要的。手术干预具有侵入性,存在损伤面神经的风险,且美容效果不佳。我们报告一例9岁女童腮腺脓肿病例,该病例需要手术引流。在文献中,小儿年龄组由先前牙齿感染引起的腮腺脓肿并不常见,仅有少数病例记录。影像学检查的首选是腮腺超声检查,它可辅助临床检查。结合彩色多普勒,超声检查对诊断、评估治疗效果有极大帮助,还有助于引导穿刺抽吸或切开引流。