儿童难治性腮腺气肿1例报道及文献回顾

Refractory pneumoparotid in children: a case report and literature review

目的 探讨腮腺气肿的治疗方法,为临床提供参考。方法 报道1例儿童难治性腮腺气肿,结合文献对腮腺气肿的诊疗进行回顾分析。结果 该例患儿无明显诱因腮腺肿大1个月余,经抗炎治疗、心理干预治疗、物理加压治疗等保守治疗后无效,患儿既往有脑瘫伴癫痫病史,存在非自主性鼓颊行为,考虑为难治性病例。经腮腺导管结扎及腮腺浅叶部分切除术后得到根治。文献回顾表明,腮腺气肿是一种罕见的腮腺肿大,多为口腔内压力增加引起空气经腮腺导管返流入腮腺内所致,其诊断主要依靠间歇性的腮腺肿胀等临床表现及超声、CT、MRI、造影等影像学检查手段。现阶段治疗措施主要包括保守抗炎治疗、物理治疗、心理干预,手术治疗是难治性腮腺气肿的最终治疗手段。结论 腮腺气肿有进一步发展为腮腺炎症的可能,一般采取保守治疗,对于一些重症、复发性以及依从性差的病例,需要进行手术治疗。

Objective To discuss the treatment of pneumoparotid and to provide a reference for clinical practice.Methods A case of refractory pneumoparotid was reported, and the diagnosis and treatment of parotid emphysema were reviewed and analyzed in combination with the literature.Results This child had parotid gland enlargement without any obvious cause for more than 1 month. Conservative treatment, such as anti-inflammatory agents, psychological interventions and physical compression were ineffective. The patient had a history of cerebral palsy with epilepsy and involuntary cheek bulging behavior. Therefore, we considered it a refractory case. It was cured after parotid duct ligation and partial parotidectomy of the superficial lobe. A literature review showed that a pneumoparotid is a rare parotid enlargement. Most of the clinical cases were considered to be caused by the return of air into the parotid gland through the parotid duct due to an increase in oral pressure. The diagnosis of pneumoparotid mainly depends on intermittent parotid gland swelling and other clinical manifestations and imaging examination methods, such as ultrasound, CT, MRI and angiography. Its treatment mainly includes conservative anti-inflammatory treatment, physical therapy and psychological intervention. Surgical treatment is indicated for refractory parotid emphysema.Conclusion Pneumoparotid cases may further develop into parotid inflammation, which is generally treated conservatively. For some severe, recurrent and poor compliance cases, surgical treatment is sometimes needed.