SIALADENITIS AND MAJOR SALIVARY GLAND TUMORS IN CHILDREN: EXPERIENCE AT LOS ANGELES CHILDRENS HOSPITAL AND A REVIEW OF THE LITERATURE.

Except for mumps, the benign lesions most frequently seen in the salivary glands of a child are parotitis, hemangioendotheliomas and mixed tumors. Carcinoma and sarcoma are uncommon. Rapid growth and pain are features of malignant change. Chronic parotitis usually subsides under conservative treatment. If operation is necessary, total parotidectomy is advisable. Scout x-ray films and sialangiographic examination are useful in differentiating an inflammatory lesion from a neoplastic growth.The treatment of choice for a non-inflammatory tumor is surgical excision, for most parotid tumors are radioresistant. Small masses should be completely excised for pathological evaluation. Since operation entails risk of damage to the seventh nerve, incisional biopsy may occasionally be indicated in the case of a large diffuse lesion for it is very likely to be benign and operation unnecessary. The risks of seventh nerve damage are magnified in a child as the anatomic structures are smaller and the nerve lies in a more superficial position.