Parotid glands are one of the major types of salivary glands in the body. The glands sit low on each side of the face and secrete saliva. There are two parotid glands with each one located in front of each ear.
Major salivary glands:
- The submandibular gland (under the jaw)
- The sublingual gland (under the tongue)
All the salivary glands attach to a tube called the duct. The duct is responsible for transporting saliva from the gland to the mouth. The particular duct which is attached to the parotid gland is known as Wharton’s duct.
Function of the Parotid Gland
The function of the parotid gland and the other two major salivary glands is to produce and secrete saliva which is a substance that helps in digestion of food, lubrication of the mouth and inhibits dental decay.
Diseases of the Parotid Gland
There are a number of medical conditions which can affect the salivary glands, such as dry mouth, stones, infections and tumours.
- Xerostomia (Dry Mouth): When the salivary glands are not functioning properly and stop or produce too little saliva, you can develop a dry mouth also medically known as xerostomia. There are a number of potential causes of this condition, including:
- Radiation therapy
- Sjogren’s syndrome (an autoimmune disease)
- Diabetes
- High blood pressure
- Hepatitis C
- Lymphoma
- Medications such as antihistamines and chemotherapy drugs
- Sialadenitis (Infection): Sialadenitis is a viral or bacterial infection that can affect the parotid and submandibular gland. It is caused by the slowed drainage from the gland due to a partial obstruction resulting in a secondary infection. The symptoms include:
- Fever
- Tenderness of the cheek
- Swelling
- Pain with eating
- There can be some pus where the duct opens into the mouth
Sialadenitis is most common in individuals with chronic illness or who are dehydrated. Treatment depends on the cause and it may include:
- Antivirals or antibiotics
- Warm compresses
- Massage of the gland which is often painful
- Sucking on lozenges or cough drops so as to stimulate the flow of saliva which helps in washing out the infection
If the infection is not treated promptly, an abscess may form and it may require drainage. A chronic form of sialadenitis is usually related to an obstruction rather than an infection. In such a case, surgery is needed to be performed on all or part of the gland as a treatment option.
- Sialolithiasis (Obstruction): This is an obstruction that is caused due to a stone (calculus) blocking the Wharton’s duct (the duct that carries saliva to the mouth). The obstruction causes swelling and pain on the side of the face of the affected gland. Not drinking enough fluids or taking medication that reduces saliva production can cause the formation of the stone. Initial treatments may include:
- Massaging the gland
- Drinking lots of fluids
- Sucking on a vitamin C lozenge or lemon drop to trigger saliva production
If the above treatment don’t work, your doctor can use a special medical instrument to remove the stone. If the stones are severe and chronic, the parotid gland itself may be removed, though this is usually avoided as much as possible.
Other causes of obstruction of the parotid gland include:
- Tooth eruption due to trauma
- Dentures compressing the duct opening
- Foreign bodies or mucous plugs that get into the duct
- A neoplasm (tumour) or a swollen lymph node that blocks the duct.
- Inflammatory/ Infiltrative disorders of the parotid gland: There are a number of medical disorders which may result in enlargement of the parotid gland, by either infiltrating the gland or causing inflammation in it. These include:
- Sjogren syndrome
- Diabetes
- Sarcoidosis
- Alcoholism
- Certain medications
- Mumps (Viral) Infection and the parotid gland: Mumps is the most common viral infection of the salivary gland and it causes enlargement of both parotid glands. Although there is a vaccine against it, outbreaks still occur but in rarity.
- Tumours: The parotid gland can also develop masses or growths known as tumours which are often benign rather than malignant (cancerous). In contrast, tumours of the minor salivary glands and the other major salivary glands are often malignant.
It is important to talk to your doctor if you notice any swelling or tenderness over your parotid gland. This is because your discomfort could not only be signalling an infection or stone which should be treated, but it could also be indicating an underlying medical condition.
Next Step
At King’s College Hospital, we focus on offering an exemplary service, from initial consultation through to the final diagnosis and treatment and beyond. Our team of expert doctors and nurses are here to offer tailored management and treatment of your condition, and to answer any questions that you might have throughout your time with us. Whatever you need us for, we’re just a phone call away.
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