A review of acute postoperative sialadenitis in children

Int J Pediatr Otorhinolaryngol. 2017 Jan;92:50-55. doi: 10.1016/j.ijporl.2016.11.008. Epub 2016 Nov 12.

Abstract

Objective: Acute postoperative sialadenitis is a previously described rare entity that has occurred following general anesthesia and has also been associated with prolonged neurosurgical procedures. We aim to better characterize this entity while performing a literature review regarding potential etiologies, diagnosis, airway management and treatment options.

Methods: A retrospective chart review was performed at a pediatric tertiary care center from 2000 to 2014. Charts were selected for the study utilizing an ICD-9 diagnosis of sialadenitis occurring within two weeks of a surgical procedure. Data including age, gender, medical history, preoperative diagnosis, operation length, time to symptom onset, and subsequent management were collected. An additional literature review was performed focusing on reports of post-operative acute sialadenitis involving airway compromise.

Result: 244 charts were reviewed and 4 patients met inclusion criteria. The average time to symptom onset was 4.3 days (range 1 h-12 days) following conclusion of the surgical procedure. Symptoms ranged from mild inflammation of the parotid gland to rapid swelling of the neck necessitating intubation. All patients were treated with standard sialadenitis treatment including hydration, antibiotics, and airway management as needed.

Conclusion: To our knowledge this is the first case series reviewing this entity specifically within the pediatric population. There appears to be two distinct categories of postoperative sialadenitis; one of which presents very acutely and results in massive neck swelling and airway compromise. It is important for practicing Otolaryngologists to be aware of this potentially life-threatening complication in the immediate postoperative period.

Keywords: Neck swelling; Postoperative; Sialadenitis; Surgical positioning.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Airway Obstruction / etiology
  • Child, Preschool
  • Edema / etiology*
  • Female
  • Humans
  • Male
  • Parotid Gland
  • Postoperative Complications / etiology*
  • Postoperative Period
  • Retrospective Studies
  • Sialadenitis / complications
  • Sialadenitis / etiology*
  • Sialadenitis / therapy
  • Time Factors
  • Young Adult