Pneumoparotitis as a complication of long-term oronasal positive airway pressure for sleep apnea

Head Neck. 2018 Jan;40(1):E5-E8. doi: 10.1002/hed.25003. Epub 2017 Nov 17.

Abstract

Background: Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation.

Methods: We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea.

Results: A diagnosis of pneumoparotitis was made by CT scan in case 1 and sialography in case 2. Patients were advised to transition from oronasal to nasal-only CPAP. One patient was successfully transferred and had good symptomatic improvement, whereas the second patient did not tolerate nasal CPAP and had persistent symptoms on oronasal CPAP.

Conclusion: Long-term use of oronasal CPAP is a potential cause of pneumoparotitis.

Keywords: obstructive sleep apnea syndrome; oronasal continuous positive airway pressure (CPAP); parotitis; pneumoparotitis; primary Sjögren syndrome; salivary glands.

MeSH terms

  • Continuous Positive Airway Pressure / adverse effects*
  • Continuous Positive Airway Pressure / methods
  • Edema / diagnostic imaging
  • Edema / etiology*
  • Edema / physiopathology
  • Endoscopy / methods
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Parotitis / diagnostic imaging
  • Parotitis / etiology*
  • Parotitis / physiopathology
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Sialography / methods
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / therapy*
  • Time Factors
  • Tomography, X-Ray Computed / methods