Parotid gland

introduction

A person produces around one and a half liters of saliva every day. The parotid gland is primarily responsible for the production of this enormous amount of fluid (Parotid gland or Parotid gland) involved. It is the largest salivary gland of the mouth and jaw area, which both humans and all other more highly developed vertebrates have.

However, it differs from the other salivary glands not only in its size and location, but also in the composition of the saliva it produces and therefore at least partially in its function. The parotid gland is an indispensable part not only of our digestive system, but also of our immune system.

Anatomy and function of the parotid gland

In the case of man there is that Parotid gland on both sides of the face. It covers roughly the back of the lower jaw bone and is therefore in front of and under the ear. The duct runs along the large masticatory muscle (Masseter muscle) of the lower jaw, penetrates it and ends at the level of the first two upper molars in the oral cavity. Its opening can be felt here as a sublimity and is often wrongly ascribed to bite scars.

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The salivary gland, which weighs around 20 to 30 grams, consists mainly of gland cells that produce a purely "serous", i.e. very watery, saliva that is rich in proteins and enzymes. This is in contrast to the other salivary glands of the head, which produce a rather low-protein, but mucous (mucous) saliva.

As far as the enzymes contained in the saliva of the parotid gland are concerned, the enzyme "alpha-amylase" is of particular importance. This serves to break down carbohydrates and thus takes over the function of pre-digesting the food that is fed in before it reaches the stomach. This is also the reason why bread begins to taste sweet after prolonged chewing - the starch is broken down into glucose by the alpha-amylase.

In addition, the saliva of the parotid gland also contains immunoglobulins, i.e. antibodies, which serve the immunological defense in the oral cavity. These antibodies in combination with other proteins that promote wound healing ensure that wounds in the oral cavity usually heal very quickly and without further complications.

Apart from this, the parotid gland is an extremely important structure, as two major anatomical structures run through it. First and foremost, this is the facial nerve (Facial nerve), which is particularly responsible for controlling the facial muscles (facial muscles). In addition it runs through the parotid with the External carotid arterywhich is a branch of the great carotid artery (Common carotid artery) is also a major blood vessel. Both the facial nerve and the said artery divide into a series of branches as they run through the parotid gland.

Parotid disorders

Pain in the parotid gland

Diseases of the parotid gland are not uncommon, even if fewer people are affected overall. Many of them can also be uncomfortable or even very annoying. In particular, inflammation of the parotid gland and salivary stones can sometimes cause severe pain (see: Salivary stone ear). Depending on the severity of the underlying disease, this can also be accompanied by swelling of the upper neck area and reddening of the skin surrounding the parotid gland. If the inflammation is strong enough, general symptoms such as fever and fatigue can also occur.

Since inflammation of the salivary gland can become chronic, should it occur more often, treatment of the disease is definitely advisable. This is usually done with antibiotics. To relieve the pain, pain relievers such as ibuprofen, paracetamol or, in the case of severe pain, metamizole (Novalgin / Novaminsulfone) prescribed. These not only have a pain-relieving effect (analgesic), but also anti-inflammatory (anti-inflammatory), which also benefits the treatment of inflammation.

More information can be found here: Pain in the parotid gland

Blocked parotid gland

If there is an inflammation of the salivary gland, there is often a salivary stone behind it, which blocks the duct of the salivary gland. As a result, bacteria like the Staphylococcus aureus, reproduce largely unhindered in the salivary gland, resulting in the typical symptoms of salivary gland inflammation with pain and swelling of the gland.

The reason for the formation of salivary stones (Sialolithiasis) is largely unclear to this day. In any case, metabolic disorders and disorders of saliva production have a beneficial effect (Dyschyly), which lead to high levels of calcium. This significantly promotes the formation of salivary stones, which typically consist of calcium phosphate - a salt that urinary stones are often made of.

A blockage of the parotid salivary duct by small salivary stones can in some cases be resolved by sucking sugar-free candy or chewing gum in combination with a massage of the parotid gland. This is called "salivation".

Inflammation of the parotid gland

If the parotid gland hurts, this is in most cases an inflammation of the salivary gland (Parotitis) responsible. The inflammation can even lead to swelling of the neck area and reddening of the skin covering the gland. General symptoms of an infection, such as fatigue and fever, can also occur if the inflammation is appropriate. Inflammation of the parotid gland is usually the result of another disease of the salivary gland, such as salivary stones or impaired saliva production. This can then lead to a colonization of the salivary gland by bacteria, such as the bacterium Staphylococcus aureus, and cause bacterial inflammation. Viral inflammation of the parotid gland, for example caused by the well-known mumps virus, has become rare thanks to vaccines that are available worldwide. However, salivary stones can cause pain even without a subsequent inflammation.

Since failure to treat inflammation can lead to the disease becoming chronic, adequate therapy is of great importance. In viral infections, anti-inflammatory drugs and pain relievers play a role.

If the infection is bacterial, antibiotics should also be prescribed. Adequate oral hygiene also contributes to a quick recovery. This also includes the so-called "saliva loosening". Simply by sucking (sugar-free) candy or chewing chewing gum, the production of saliva and thus the flushing out of pathogens is promoted.

Read more on the topic: Inflammation of the parotid gland

Parotid cancer

Parotid cancer is also often referred to as parotid cancer. Parotid gland cancer is a rarely occurring form of cancer that usually grows very slowly and does not initially cause any pain.

The causes of parotid gland cancer are chronic inflammation in the area of ​​the salivary glands, but bacterial contamination can also, in rare cases and under certain circumstances, lead to parotid gland cancer. In addition, salivary stones as well as chronic alcohol and nicotine consumption are also considered to promote the growth of the tumor.

The first signs of parotid gland cancer can be swelling or pain. You can find more information on this under Swelling of the parotid gland and pain in the parotid gland. At an advanced stage, facial paralysis can also occur. This also includes impairments to the eyes.

If you suspect a parotid gland cancer, your family doctor will usually refer you to an ear, nose and throat doctor, who will then first take a closer look at the situation simply by palpation. In addition, biopsies of the tissue can be performed, which provide information about whether it is a benign or malignant tumor. With the help of imaging techniques in the form of ultrasound, CT and MRI, the location, size and type of the tumor can finally be determined.

Parotid cancer must and should be surgically removed in any case. Even if the tumor is benign, there is a very high probability that it will turn into a malignant tumor over time, which will cause daughter ulcers (metastases). During an operation, the entire parotid gland is removed, which is often complicated and problematic because a facial nerve (nervus facialis) that controls facial expressions runs directly through the parotid gland. This can lead to facial paralysis. The probability of this, however, is very low and is less than 1%.

If you want to find out more about the disease of parotid gland cancer, read our article: Parotid gland cancer

Lump in the parotid gland - what could be behind it?

A lump in the parotid gland can usually be felt or recognized by a layperson. A lump in the parotid gland can hide various causes.

1. A tumor can be the cause of the lump formation. This can be a benign or a malignant tumor. These two types cannot be distinguished by simply palpating them, which is why an ENT doctor should always be consulted who will examine the whole thing more closely. A tumor can then be diagnosed as benign or malignant through various examinations. All further information can be found in our article Parotid Gland Cancer.
2. A swelling of the parotid gland can also hide an abscess, i.e. a large collection of pus. These can easily be caused by inflammation rising from the mouth area.
3. Possible stone formation in a gland duct can also be the cause of the clinical picture, so that the flow of saliva is prevented. The result is swelling of the parotid gland with resulting pain. The pain is usually caused by increased tissue pressure within the parotid gland. In extreme cases, this can even lead to impairment of the facial nerve running through the parotid gland and thus to facial muscle paralysis. This should also be clarified by an ENT doctor in any case.

Parotid stones

If stones form in a salivary gland or its duct, it is called sialolithiasis. As a rule, it is not the parotid gland that is affected, but the mandibular salivary gland. In only one fifth of the cases, salivary stones arise in the Parotid gland. Salivary stones occur relatively frequently with around 30 to 50 cases per million inhabitants. Men and women are affected equally often. The cause of the formation of salivary stones is usually a disturbed saliva secretion (dyschyly) or a change in the composition of the saliva. The stones themselves usually consist of something that not only occurs in urinary stones, but is also a major component of our bones.

Symptoms of sialolithiasis occur particularly when eating, i.e. at the time of the greatest saliva production. This mainly results in pain and swelling of the respective gland in the case of the parotid gland.

Read more on the topic: Parotid stones

A treatment of salivary stone formation or parotid stone formation takes place depending on the size of the stones. Small stones can possibly be washed out by the so-called "saliva loosening". This is simply a matter of promoting saliva production by sucking or chewing candy or chewing gum. A massage of the parotid gland can possibly provide additional relief. Larger stones, on the other hand, can be removed surgically. An alternative to this is ultrasound therapy, in which the salivary stones are broken up and then washed out by the saliva. Apart from this, there is also salivary duct endoscopy as a treatment alternative (Sialendoscopy), in which small stones located in the salivary gland duct can be removed under sight using small forceps or a basket and narrow areas in the duct can be expanded.

Read more on the topic: Salivary stone removal

Swelling of the parotid gland

Swelling of the parotid gland can be the result of various diseases. These include above all inflammation of the parotid gland, but also the formation of parotid stones and various benign as well as malignant tumor diseases. Especially in the case of an inflammation of the salivary gland, there are other symptoms such as pain, especially when pressure is applied to the swelling, reddening of the surrounding skin and general symptoms such as fever and fatigue.

Inflammation of the parotid gland (Parotitis) can be either viral or bacterial, although viral parotid disease (mainly caused by mumps) has become rare these days. Bacterial inflammations, on the other hand, are relatively common and are mostly based on a pre-existing underlying disease such as salivary stones, which hinder the flow of saliva and thus create a good environment for bacteria to multiply.

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However, salivary stones in themselves can lead to swelling of the parotid gland even without the accompanying inflammation. This is probably caused by unexplained metabolic disorders. However, salivary stones are formed (Sialolithiasis) significantly more often in the mandibular salivary gland (Submandibular gland) because their saliva has a significantly higher calcium content.

In addition to salivary stones and inflammation of the salivary glands, tumor diseases can also cause swelling Parotid gland cause. These can be both benign (benign) or more malicious (malignant) Be nature. Benign tumors usually have a very good prognosis, but should be removed surgically as there is still a low probability of degeneration. Men in particular are affected by benign salivary gland tumors. Malignant salivary gland tumors are less common. Your treatment is usually carried out by a surgical procedure in which half or the entire salivary gland is removed. In some cases, however, the tumor can also be irradiated.

You can find detailed information on this topic at: Swelling of the parotid gland

Which doctor treats diseases of the parotid gland?

An ear, nose and throat doctor is usually responsible for diseases of the parotid gland. An ENT doctor deals with the branch of medicine that is responsible for most of the head and neck area, excluding the brain.

Lymph nodes of the parotid gland

Lymph nodes in general are a kind of "filter station" for the lymph fluid within the lymphatic vessels. This fluid is located within the lymphatic vessels and represents the link between the tissue fluid and the blood.

The lymph nodes of the parotid gland are also known as parotid lymph nodes in medical jargon and are a group of lymph nodes in the head area. Its location is limited to the parotid gland and its glandular tissue.

The parotid lymph nodes take in the lymph from the parotid gland, parts of the nose, the external auditory canal, and the eyelids and conjunctiva.