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Face and Jaw Surgery

Swelling of jaw

08/24/2007

Question:

I periodically incur severe (painless) swelling immediately in front and just below either ear. The swelling incident can last for one to several hours, and I believe is related to a burning sensation that occurs in the ear just prior to swelling. The large `swelling area` that results is quite pronounced and about the size of a small fist, and when felt, has a solid mass type feel. When it dissappates there is nothing left to notice. I have sought medical advice on a number of occasions, and recently I have been told by 2 separate GP`s there is nothing in that region of the face capable of swelling. The problem is becoming more frequent, so I am anxious to know what to do.

Thank you

Answer:

Your history suggests the swelling is likely due to the parotid gland. The salivary glands are glands that secrete saliva into our mouths. We have three major pairs of salivary glands. The parotid gland is the largest of the salivary glands. It is found wrapped around the side of jawbone (in front and just below the ear), and it secretes saliva through duct (Stensen's duct) into the mouth, to facilitate chewing and swallowing. The most common symptom of salivary gland disease is swelling of the gland. Rapid swelling typically occurs with inflammatory disorders. Bilateral swelling is more typical of infectious or autoimmune disorders, but may also occur with some tumors.

Your history suggests chronic sialadenitis. Decreased salivary flow with stasis is a key factor in chronic sialadenitis. This condition is more common in the parotid gland. Its development is often associated with a previous episode of acute inflammation of glands with subsequent glandular destruction.

Symptoms include recurrent mildly painful swelling of the parotid that often accompanies eating. Approximately 80% of patients experience dryness of mouth. A thorough search is made for treatable predisposing factors such as a stones in ducts or stricture. You need to see an ENT or Head and Neck Surgeon who will examine you and likely obtain the necessary CT scans. Treatment depends on the diagnosis and the cause.

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Response by:

Likith V Reddy, MD, DDS, FACS Likith V Reddy, MD, DDS, FACS
Formerly:
College of Medicine
University of Cincinnati