O Thiede1, W Stoll, F Schmäl. 1. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde des Universitätsklinikums Münster. thiedeo@uni-muenster.de
Abstract
OBJECTIVE: The purpose of this paper was to analyse parotideal abscesses on the basis of a larger number of patients. PATIENTS AND METHODS: The data of 36 patients (mean age 44 years) with a parotideal abscess was analysed. RESULTS: Ultrasound scan was always necessary to verify the diagnosis. The surgical drainage was done under myoelectric monitoring of the facial nerve. Only in 1 patient a temporary minor paralysis of the mandibular branch was noticed. The most common bacteria were Staph. aureus, Streptococcus, and Peptostreptococcus. In 2 cases a tuberculosis and in 2 children an atypical mycobacterial infection was discovered. In another patient a metastasis of a squamous cell carcinoma was found. CONCLUSIONS: In every patient with an acute swelling of the parotid region without consideration of age, number of leucocytes or a typical fluctuation, an ultrasound scan should be used. The surgical drainage of the abscess should be done under myoelectric monitoring (Cave: muscle relaxant). In every case, a specimen for microbiological analysis (bacterial determination) and a biopsy (to exclude malignoma or atypical mycobacteria) are necessary. A peri- and post-operative therapy with a combination of aminopenicillin and clavulanic acid or with cephalosporine is recommended.
OBJECTIVE: The purpose of this paper was to analyse parotideal abscesses on the basis of a larger number of patients. PATIENTS AND METHODS: The data of 36 patients (mean age 44 years) with a parotideal abscess was analysed. RESULTS: Ultrasound scan was always necessary to verify the diagnosis. The surgical drainage was done under myoelectric monitoring of the facial nerve. Only in 1 patient a temporary minor paralysis of the mandibular branch was noticed. The most common bacteria were Staph. aureus, Streptococcus, and Peptostreptococcus. In 2 cases a tuberculosis and in 2 children an atypical mycobacterial infection was discovered. In another patient a metastasis of a squamous cell carcinoma was found. CONCLUSIONS: In every patient with an acute swelling of the parotid region without consideration of age, number of leucocytes or a typical fluctuation, an ultrasound scan should be used. The surgical drainage of the abscess should be done under myoelectric monitoring (Cave: muscle relaxant). In every case, a specimen for microbiological analysis (bacterial determination) and a biopsy (to exclude malignoma or atypical mycobacteria) are necessary. A peri- and post-operative therapy with a combination of aminopenicillin and clavulanic acid or with cephalosporine is recommended.
Authors: Alberto Maria Saibene; Fabiana Allevi; Tareck Ayad; Jérome R Lechien; Miguel Mayo-Yáñez; Krzysztof Piersiala; Carlos M Chiesa-Estomba Journal: Acta Otorhinolaryngol Ital Date: 2022-04 Impact factor: 2.618