LXVII Chronic Asymptomatic Enlargement of the Parotid Glands

Abstract

No. 4Asymptomatic enlargement of the parotid glands seems to receive increasing attention in the United States during the last decade. Most of the earlier reports between the turn of the century and World War II came from Europe. The upsurge of interest is most likely attributed to the recognition of a definite relationship between asymptomatic parotid enlargement and various underlying diseases or conditions.There are numerous reports in the recent literature on asymptomatic parotid swelling associated with a great variety of conditions. It is out of the scope of this paper to discuss all of these reports; however, a short review of the problem is in order.One of the earliest reports by Sandwitlr' in 1905 focused the attention of the high incidence of parotid swelling in the poorly nourished fellahin of Egypt. He taught of the causative factor as chronic parotitis or obstruction of the Stensen's duct by calculi. This same group of Egyptian population was studied two decades later by

Salivary glands in alcoholism: a histologic and sialographic study

“…This is in agreement with the measurements made by Scott et al, 5 , on parotid and submandibular glands, which provided no evidence for even small degrees of acinar hypertrophy, although this has been described as a characteristic finding in alcoholic cirrhosis. 3,4 We therefore conclude that labial salivary glands probably do not develop a hypertrophic response in alcoholic patients.…”

“…3 The aetiology of this enlargement in the alcoholic patient is still unknown, but acinar cell hypertrophy has been implicated as the cause of the parotid swelling. 3,4 A disturbance on lipid metabolism that might generate fat accumulation has also been suggested. 5 There are minimal and contradictory data on salivary secretions, although the following findings have been reported: increased or decreased salivary flow rate, increased potassium levels, increased amylase levels.…”

Clinical clues to the diagnosis of cirrhosis

“…Some authors also suggest a role for glandular dysfunction [44]. In sialosis of alcoholic origin, 60% of patients with alcoholic cirrhosis present with parotidomegaly [45], the glandular enlargement being observed already in the precirrhotic phase in 12% of cases [46,47].…”

The effect of long term ethanol intake on the parotid gland in rats.

“…With chronic alcoholic pancreatitis, the situation is still more complex. The parotid gland as well as the pancreas may at first be stimulated to hypersecretion by ethanol ingestion and then become hypofunctional (Borsanyi 1962;Dreiling and Bordalo 1973).…”

“…With chronic alcoholic pancreatitis, the situation is still more complex. The parotid gland as well as the pancreas may at first be stimulated to hypersecretion by ethanol ingestion and then become hypofunctional (Borsanyi 1962;Dreiling and Bordalo 1973).The parotid glands of ethanol treated animals would be influenced in three different ways ; a) through pancreatic dysfunction, b) through alterations of autonomic nervous control influding changes of receptor function, and c) through the direct effects of ethanol on the parotid cells. In the ethanol-treated rats, the morphological changes of the parotid gland seemed rather different from those seen in the case of partial resection of the rat pancreas or with acute pancreatitis induced by ligation of the common bile duct in the rat (unpublished data).…”