Etiology of Pneumoparotid: A Systematic Review

Abstract

Pneumoparotid describes retrogradely insufflated air within the Stensen’s duct and/or parotid gland. It is a rare condition with variable causative factors. This study aimed to elucidate the clinical characteristics of pneumoparotid. Reports in all languages were evaluated following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement 2020. A literature search was conducted using electronic medical databases (PubMed, Scopus, Web of Science, EBSCO, Ovid, Google Scholar, SciElo, LILIACS, and others) from 1890 to 30 June 2022. One hundred and seventy patients (mean age; 28.4 years) from 126 studies were reviewed. Common symptoms included swelling (84.7%) and pain (35.9%). Characteristic findings were crepitus in the parotid region (40%) and frothy saliva from the orifice (39.4%). The common etiologies included abnormal habits such as blowing out the cheeks (23.5%), idiopathic (20%), self-induced (15.9%), playing wind instruments such as trumpets or flutes (8.8%), and diseases inducing coughing or sneezing (8.2%). The treatments included antibiotic therapy (30%), behavioral therapy to avoid continuing causative habits (25.9%), psychiatric therapy (8.2%), and surgical procedures (8.2%). Treatment should be individualized and etiology-based. However, the etiology was not identified in 20% of patients. Further detailed data from larger samples are required to clarify and improve the recognition of this entity.

Pneumoparotitis in a child. Clinical observation

“…В 6,5 % ЭП развивается как ятрогения (стоматологические, хирургические вмешательс тва -тонзилэктомия, неинвазивная вентиляция легких с положительным давлением, спирометрия, эндоскопия), в 10 % случаев выявлены другие причины: декомпрессия после погружения, ныряние с задержкой воздуха в полости рта и др. В 20 % вычленить этиологический фактор не удается [6]. Соответственно этиологии заболевания у детей ЭП встречаются очень редко, в основном у подростков с психологическими проблемами (самоповреждение).…”

“…Крепитация наблюдалась в 40,0 % случаев. Пузырьки или пенистая слюна из устья стенонова протока обнаружены в 39,4 % случаев [6].…”

Pediatric Idiopathic Bilateral Pneumoparotid

“…Retrograde movement of air through Stensen's duct is the cause of pneumoparotid [2]. Self-induced pneumoparotid is primarily seen in children with a mean age of 14 while other causes such as glass blowing or wind instruments are seen in primarily adults [3]. Imaging, reassurance, follow-up and antibiotics are the key to treatment.…”

Inadvertent, Self-Induced Pneumoparotitis Provoking Pneumomediastinum

“…Typically, intraoral pressures measure 2-3 mmHg but can reach 140 mmHg during activities like glassblowing, creating conditions favorable to introduction of air and oral flora into the parotid gland [1]. Other possible etiologies of pneumoparotid that have been identified include unconscious habits, diseases that induce coughing, vomiting, or sneezing, continuous positive pressure, and iatrogenic causes such as dental and surgical procedures [4].…”