Sialadenitis – Ear, Nose, And Throat Disorders
Write short note on acute parotid abscess.
Answer. It is a result of an acute bacterial sialadenitis of the parotid gland.
- It is an ascending bacterial parotitis, due to reduced salivary flw, dehydration, starvation, sepsis, after major surgery, radiotherapy for oral malignancies and poor oral hygiene.
- Parotid fascia is densely thick and tough and so parotid abscess does not show any fluctuation until very late stage.
- Causative organisms are Staphylococcus aureus (commonest), Streptococcus viridans and often others like gram-negative and anaerobic organisms.
“Living With Recurring Episodes Of Sialadenitis Tips”
Acute parotid abscess Clinical Features
- Pyrexia. malaise, pain and trismus.
- Red, tender, warm, well-localized, fim swelling is seen in the parotid region (brawny induration).
- Tender lymph nodes are palpable in the neck.
- Features of bacteremia are present in severe cases.
- Pus or cloudy turbid saliva may be expressed from the parotid duct opening.
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Acute parotid abscess Investigations
- Ultrasonography of parotid region should be done.
- Pus collected from duct orifie should be sent forculture and sensitivity
- Needle aspiration from the abscess is done to confim formation of pus.
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Acute parotid abscess Treatment
- Antibiotics are started depending on culture report.
- When it is severely tender and localized, incision and drainage is done under general anesthesia.
Skin is incised in front of tragus vertically and then parotid sheath is opened horizontally.
Pus is drained using sinus forceps and is sent for culture.
Antibiotics should be continued. - Proper hydration, mouth wash using povidone-iodine;potaium permanganate solutions, nutrition.
Often patient with parotid infection needs admission and treatment.
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