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Pneumoparotitis (also termed pneumosialadenitis[1] wind parotitis,[1] surgical mumps,[2] or anaesthesia mumps),[2] is a rare cause of parotid gland swelling which occurs when air is forced through the parotid (Stensen) duct resulting in inflation of the duct.[3]
The size of the swelling is variable, but it is soft[4] and can occur on one side or both sides.[1] It is typically non tender,[4] although sometimes there may be pain.[1] It usually resolves over minutes to hours, however occasionally this may take days.[1] The condition can be transient or recurrent.[5]
The condition is caused by raised air pressure in the mouth. [1]
Pneumoparotitis is often misdiagnosed and incorrectly managed.[5] The diagnosis is based mainly on the history.[1] Crepitus may be elicited on palpation of the parotid swelling,[1] and massaging the gland may give rise to frothy saliva or air bubbles from the parotid papilla.[1] Further investigations are not typically required, however sialography, ultrasound and computed tomography may all show air in the parotid gland and duct.[1]
Management is simply by avoidance of the activity causing raised intraoral pressure which is triggering this rare condition.[1]
Recurrent pneumoparotitis may predispose to sialectasis, recurrent parotitis, and subcutaneous emphysema[5] of the face and neck, and mediastinum, and potentially pneumothorax.[1]
The condition is rare.[5] It is more likely to occur in persons who regularly have raised pressure in the mouth, for example wind instrument players,[6] and balloon[1] and glass-blowers.[7] Cases have also been reported with bicycle tyre inflation,[1] whistling,[1] nose blowing,[1] cough[1] and valsalva manoeuvre to clear the ears.[1] It can be an iatrogenic effect of dental treatment,[1] spirometry,[1] and positive pressure ventilation.[2] Apart from these factors, the condition mainly occurs in adolescents, often self-inflicted due to psychological issues.[7][8]
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