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Salivary Gland Infections in Children – Sialadenitis

About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

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About Dr. Belinda Mantle

Dr. Mantle’s practice is focused on the diagnosis and management of pediatric patients with common ears, nose and throat disorders. She pursued sub-specialty training in pediatric otolaryngology at Children’s Hospital of Pittsburgh. Dr. Mantle is fellowship-trained in pediatric otolaryngology and is a board-certified diplomate of the American Academy of Otolaryngology/Head & Neck Surgery.


How do you treat a salivary gland infection in a child?

Question: My daughter has a painful, swollen red cheek and a mild temperature. She doesn’t want to eat because she says it hurts to eat and to chew. Her pediatrician has started her on antibiotics for a salivary gland infection.  What is this and how do you treat it?

Answer:

Salivary glands are saliva-producing tissues in the cheeks, under the jaw, and beneath the tongue.  Normally, saliva produced by the gland is drained into the mouth by a network of small tubes called ducts.

If the salivary duct becomes narrowed or blocked, saliva does not drain.  This can cause a backup of saliva which may become infected, called sialadenitis.  When this occurs in the salivary gland of the cheek, the parotid gland, it is called parotitis.  Parotitis results in swelling of the face, fever, and facial pain.  The salivary glands normally contract to produce saliva during a meal but contraction of an infected gland can also be painful.

Sialadenitis can be treated with:

  • Antibiotics – needed to kill the bacteria causing the infection
  • Sialagogues – sour foods or candies that increase salivary flow
  • Hydration
  • Gland massage
  • Warm compresses

While these methods are usually effective, in some children episodes of parotitis can recur. The most common causes of recurrent sialadenitis in children are salivary duct stones and Juvenile Recurrent Parotitis (JRP).   Juvenile Recurrent Parotitis (or Recurrent Parotitis of Childhood) is one of the most common causes of salivary gland swelling.  JRP is characterized by severe pain, fever, and swelling on one or both sides of the face every 3-4 months until puberty.  These patients are normal between episodes but the episodes are not preventable.  Treatment has traditionally been limited to aggressive surgery, including removal of the parotid gland.  Sialendoscopy now offers a conservative and effective opportunity for relief.  This procedure requires subspecialty care by a salivary gland specialist.

Fortunately, salivary gland infections in children often resolve by using the conservative measures above. See your pediatric otolaryngologist if you believe your child may be suffering from sialadenitis.

Key Points

  • The salivary glands are responsible for producing saliva and are located in the cheeks, below the jaw, and beneath the tongue.
  • Saliva is normally drained into the mouth through a small network of tubes called ducts.
  • Blocked or narrowed ducts can lead to saliva backup and sialadenitis, an infection of the salivary glands.
  • Conservative measures for sialadenitis or parotitis are antibiotics, sialagogues, hydration, gland massage, and warm compresses.
  • Recurrent parotitis is a problem for some children and may require more extensive treatment such as sialendoscopy.

Sialendoscopy is a conservative and effective approach for treatment of salivary gland stones.

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