The use of the “puffed‐cheek” computed tomography technique to confirm the diagnosis of pneumoparotitis

Lasboo, Anahita Aghaei; Nemeth, Alexander J.; Russell, Eric J.; Siegel, Gordon J.; Karagianis, Achilles

doi:10.1002/lary.20879

Cited by 12 publications

(11 citation statements)

References 5 publications

(5 reference statements)

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“…The gold standard for diagnosing pneumoparotitis is computed tomography, which reliably identifies air in the ductal system and is useful for differentiating air from calculi and inflammation [3,6]. Recent studies have suggested that a “puffed cheek” computed tomography technique has the potential to aid in diagnosis and reveal a greater prevalence [6]. Ultrasound is also useful for diagnosis [6].…”

Section: Discussionmentioning

confidence: 99%

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Pneumoparotitis

House

Lewis

2018

Clin Exp Emerg Med

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The objective is to review a case of pneumoparotitis and to discuss how knowledge of this unique presentation is important when making differential diagnoses in emergency medicine. A patient with recurrent subcutaneous emphysema of the head and neck is reviewed. Stenson’s duct demonstrated purulent discharge. Physical examination revealed palpable crepitance of the head and neck. Fiberoptic laryngoscopy and barium esophagram were normal. Computed tomography demonstrated left pneumoparotitis and subcutaneous emphysema from the scalp to the clavicles. This is an unusual presentation of pneumoparotitis and malingering. Emergency physicians should be aware of pneumoparotitis and its presentation when creating a differential diagnosis for pneumomediastinum, which includes more life-threatening diagnoses such as airway or esophageal injuries.

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Section: Discussionmentioning

confidence: 99%

“…Recent studies have suggested that a “puffed cheek” computed tomography technique has the potential to aid in diagnosis and reveal a greater prevalence [6]. Ultrasound is also useful for diagnosis [6].…”

Section: Discussionmentioning

confidence: 99%

Pneumoparotitis

House

Lewis

2018

Clin Exp Emerg Med

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“…Repeated episodes of pneumoparotid may cause to chronic inflammation, infection or sialectasis. The pathophysiologic condition of pneumoparotid has also been demonstrated by using a "puffed-cheek" technique [53], usually performed a CT examination after sialography, which mark filling defects, air in the parotid ductal system and sialoliths. Next, massaging the both patient's parotid glands, CT scan is performed highlighted a reduced amount of air and absence of contrast.…”

mentioning

confidence: 99%

“…Currently, CT is the gold-standard technique because it defines anatomy and it is not invasive.Describing air-filled dilatation of Stensen's duct, glandular acini air dilatation, collections, free air intraparenchymal and a good imaging of duct glandular system, also helps in diagnoses of extension of air-accumulation in the nearest areas of the head-neck district [2]. Puffed-cheek CT is a good technique that demonstrated a subtle, but definite increase in intraductual and intraglandular parotid air when is compared to the simple CT [53].…”

mentioning

confidence: 99%

Pneumoparotid and Pneumoparotitis: A Literary Review

Gazia

Freni

Galletti

et al. 2020

IJERPH

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Pneumoparotid is a rare condition of parotid swelling. The presence of the air in gland parenchyma is caused by an incompetent Stensen’s duct with high pressure may cause the acini’s rupture. We reviewed 49 manuscripts, from 1987 to today, that enrolled a total of 54 patients with pneumoparotid. Our review evaluated the following evaluation parameters: gender, age, etiology, clinical presentation, treatment, days of resolution after diagnosis, relapse and complications. The most frequent etiology is self-induction by swelling the cheeks (53.7%). This cause mainly involves children (74%), for conflicts with parents, excuses for not going to school, nervous tics or adults (16%) with psychiatric disorders. Iatrogenic causes are also frequent (16.6%), for dental treatments (55.5%) or use of continuous positive airway pressure (CPAP) (33.4%). Medical therapy is the most practiced (53.7%), in most cases it is combined with behavioral therapy (25.9%) or psychotherapy (25.9%). Surgery is rarely used (9.2%) as a definitive solution through parotidectomy (50%) or ligation of the duct (50%). The most common complication is subcutaneous emphysema (24.1%), sometimes associated with pneumomediastinum (5.5%). Careful treatment and management are necessary to ensure the resolution of the pathology and counteract the onset of complications.

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“…The visualization of small sialoliths can be further improved by hyperflexion of the neck, which eliminates artifacts due to dental restorations (Figure 1). The puffed-cheek technique recently has been reported to be effective in the radiologic diagnosis of pneumoparotitis [8]. The surfaces of the oral cavity that are often in contact are the buccal (cheek) mucosa more posteriorly or the labial (lip) mucosa more anteriorly, and the alveolar (gingival) mucosa of the mandible and maxilla.…”

Section: Parotid Spacementioning

confidence: 99%

Using Dynamic Maneuvers in the Computed Tomography/Magnetic Resonance Assessment of Lesions of the Head and Neck

et al. 2013

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Despite advances in technology, the radiologic assessment of certain head and neck lesions may still pose difficulties because of the complex anatomy of this region, the small and mobile structures that this region harbors, and the apposition of mucosal surfaces in the neutral position. Certain maneuvers have been described in the literature to overcome these difficulties. We review the use of the Valsalva and the modified Valsalva maneuver, the puffed-cheek technique, phonation, and inspiration, with possible applications in head and neck imaging.

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The use of the “puffed‐cheek” computed tomography technique to confirm the diagnosis of pneumoparotitis

Cited by 12 publications

References 5 publications

Pneumoparotitis

Pneumoparotitis

Pneumoparotid and Pneumoparotitis: A Literary Review

Using Dynamic Maneuvers in the Computed Tomography/Magnetic Resonance Assessment of Lesions of the Head and Neck

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