What is the best way to treat chronic obstructive parotitis?

In the treatment of chronic obstructive parotitis, it is important to pay attention to the understanding of the symptoms. Patients often experience repeated swelling of the parotid glands, or mild pain problems. Attention should be paid to the correct use of medications to inhibit bacteria and reduce retrograde infection of the glands.

1. Most cases occur in middle age. It is usually unilateral, but can also be bilateral. Patients often do not know the time of onset, and most of them seek medical treatment due to recurrent swelling of the parotid gland. In about half of the patients, the swelling is related to eating and is accompanied by mild pain during the attack. Some patients experience parotid gland swelling, while others rarely experience it within a year. Most of the attacks occur more than once a month. The attack is accompanied by mild pain.

2. For some patients, parotid swelling has no clear relationship with eating. They feel swelling in the parotid area in the morning. After a slight massage, "salty" liquid flows out of the catheter, making the local area feel light. On examination, the parotid gland was slightly heavy, of medium hardness, and slightly tender. The duct opening is slightly red and swollen. Squeezing the parotid gland will cause turbid "snowflake-like" or sticky egg white-like saliva to flow out of the duct opening, and mucus plugs may sometimes be seen. In patients with a long course of illness, a rough, cord-like parotid duct may be palpated under the buccal mucosa.

3. Most patients are caused by local reasons. For example, when wisdom teeth erupt, the mucosa of the duct opening is bitten, and the scar heals, causing stenosis of the duct opening. A few are caused by duct stones or foreign bodies. Due to duct stenosis or foreign body obstruction, the duct distal to the obstruction expands and saliva stagnates. The parotid duct system is long and narrow, which makes saliva easy to stagnate, and is also one of the causes of chronic obstructive parotitis.

4. Most of them are caused by specific reasons, so the focus is on eliminating the causes. If you have salivary stones, remove them first. If the catheter opening is narrow, a blunt-tipped probe can be used to dilate the catheter opening. Drugs are also injected into the catheter, such as iodized oil and antibiotics, which have certain antibacterial and antimicrobial effects. Other conservative treatments may also be used, including massaging the parotid gland forward after delivery to encourage secretions to drain. Chew sugar-free gum to stimulate saliva secretion. Gargling with warm salt water has an antibacterial effect and reduces retrograde glandular infection. In recent years, some scholars have used sialoscope to flush the duct and infuse drugs, with good results. If the above treatments are ineffective, surgical treatment may be considered, including parotid lobectomy to preserve the facial nerve.