Acute unilateral enlargement of the parotid gland immediately post craniotomy in a pediatric patient: a case report

Abstract

A temporary acute unilateral enlargement of the parotid gland or "anesthesia mumps" has been described in both surgical and anesthesia literature. It has been described in elderly, dehydrated, poorly nourished, and post-operative patients. We present a 5-year-old patient who underwent a left temporal craniotomy for seizure focus resection and quadriceps muscle biopsy. Immediately post procedure, he was noted to have an acute unilateral enlargement of the right parotid gland. We report acute unilateral parotitis as a possible, but uncommon, complication of positioning in the pediatric population and to discuss possible pathophysiology and prevention, as well as a review of the available literature.

Paediatric salivary gland pathology

“…11 Acute "anesthesia sialadenitis" may follow peritoneal and, more recently recognized, cranial surgery. 12 Acute parotitis may accompany inflammatory bowel disease. 13 As many granulomatous diseases affect lymph nodes, it is unclear whether granulomatous inflammation targets the salivary glands or the intraglandular lymph nodes with secondary spillover affecting salivary parenchyma.…”

Sialadenitis following blepharoplasty: An unusual sequelae

“…This condition has been described previously in the elderly, dehydrated, poorly nourished, and postoperative patients. [23] This condition has been commonly reported after endotracheal general anesthesia. Matsuki et al .…”

Unilateral parotid swelling, following caudal block without airway device placement

“…(1). It occurs immediately following surgery, usually is unilateral, sometimes painful, and resolves spontaneously (2). Most previously reported cases have been in adult patients, after endotracheal intubation or laryngeal mask airway placement, in general anesthesia.…”

“…Acute parotid gland swelling after general anesthesia, named as anesthesia mumps, is a rare postoperative complication (2–4). It might be associated with temporary duct obstruction, caused by local mechanical compression, vascular congestion, because of prolonged neck flexion and remaining so long in the prone position (4), which may affect the drainage of Stensen’s duct and cause stasis in the parotid gland.…”

“…It might be associated with temporary duct obstruction, caused by local mechanical compression, vascular congestion, because of prolonged neck flexion and remaining so long in the prone position (4), which may affect the drainage of Stensen’s duct and cause stasis in the parotid gland. Acceleration of parotid gland secretion by premedications and anesthetic agents (2) remains unclear, as well as dehydration. A blocking of the duct, caused by swelling of the lining’s epithelial cells resulting in retention of saliva, is also considered as another contributing factor (5).…”