Parotid abscess: mini-pictorial essay

Abstract

Bacterial and viral infection of the intraparotideal and periparotideal lymph nodes, or of the glandular parenchyma, can lead to inflammatory and subsequently suppurative changes, which can result in abscess formation. Sonography allows a detailed morphological evaluation of the gland and has an important value, complementary to clinical examination, in the study of parotid inflammatory diseases. Specifically, sonography defines lesion's characteristics and, in a large number of cases, also its nature and, among the various imaging techniques, it is considered first-line imaging for the evaluation of parotid abscesses, which are characterized by hypo-anechoic lesions, with irregular margins. Color Doppler signals are peripheral to the abscess. If combined with color Doppler, sonography is important not only in diagnosis, but also in the evaluation of therapeutic efficacy and as a guide to the aspiration and drainage of abscesses. The rarity of some of these lesions led us to publish this mini-pictorial essay.Keywords Salivary glands Á Sonography Á Abscess Riassunto Le infezioni batteriche e virali dei linfonodi intraparotidei e periparotiedei, o del parenchima ghiandolare, provocano una risposta infiammatoria e successivamente possono portare a suppurazione e a formazione di ascessi. L'ecografia consente di effetuare una valutazione morfologica dettagliata della ghiandola ed ha un valore importante, complementare all'esame clinico, nello studio delle malattie infiammatorie parotidee, poichè permette di definire le caratteristiche della lesione e, in un gran numero di casi, anche la loro natura; di conseguenza, tra le diverse metodiche di imaging, l'ecografia viene considerata quella di primo livello per lo studio degli ascessi parotidei, che si presentano come lesioni ipo-anecogene, con margini irregolari. La valutazione mediante color-Doppler mostra la presenza di segnali periferici alla lesione ascessuale. Oltre all'importanza per la diagnosi, l'ecografia, in combinazione con il color-Doppler, è utile nel follow-up e per guidare gli esami bioptici ed il drenaggio delle lesioni. Poichè alcune di queste lesioni sono rare, abbiamo deciso di pubblicare questo mini-pictorial essay.

Parotid abscess at a single institute in Korea

“…Parotid abscess can arise from ascending infection via Stensen duct, or secondary to bacteraemia. [ 1 , 5 , 6 ] Parotid abscess is commonly associated with elderly debilitated, or immunocompromised patients. [ 1 – 4 ] In this study, there were 7 patients (53.8%) in old age, or immunocompromised state.…”

“…The most common symptom of parotid abscess is painful swelling at the angle of the jaw, and patients had presented this symptom. [ 1 , 2 , 5 , 7 , 8 ] Regional lymphadenopathies, facial nerve palsy, or purulent secretion from Stensen duct can sometimes be detected. [ 1 , 7 ] Facial nerve palsy may develop due to virulent microorganism, perineuritis, or nerve compression.…”

Color doppler ultrasonography to evaluate hypoechoic areas in pressure ulcers: A report of two cases

“…In contrast, previous studies report that in abscess formation, highly vascularized connective tissue surrounds the necrotic area, and this can be detected by CDM. [ 8 9 ] Color Doppler sonographic images of soft-tissue abscess reveal increased vasculature in the abscess wall. [ 10 ] In this study, B-mode images were similar for necrotic tissue and inflammatory edema at baseline (the first examination); however, CDM revealed increased vascularity around the periphery of the abscess after 3 weeks.…”

Standardy badania ślinianek – aktualizacja

“…The formation of an abscess in the salivary gland produces a non-specific image ( Fig. 22 ), but as with most inflammatory processes, several characteristic elements can be found, such as enlarged satellite lymph nodes or increased blood flow in the dilated vessels surrounding the irregular anechoic and hypoechoic spaces ( 1 , 3 , 19 ) .…”