An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 14 , ISSUE 3 ( September-December, 2022 ) > List of Articles


Pneumoparotid and Subcutaneous Emphysema in a Man with Psychiatric Disorders

Cosimo Galletti, Francesco Ciodaro, Francesco Freni, Galletti Bruno

Keywords : Computed tomography scan, Head and neck region, Parotid gland, Parotid swellings, Parotitis, Salivary gland

Citation Information : Galletti C, Ciodaro F, Freni F, Bruno G. Pneumoparotid and Subcutaneous Emphysema in a Man with Psychiatric Disorders. Int J Otorhinolaryngol Clin 2022; 14 (3):110-113.

DOI: 10.5005/jp-journals-10003-1411

License: CC BY-NC 4.0

Published Online: 20-03-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Pneumoparotid is an uncommon clinical presentation of parotid swelling. An incompetent Stensen's duct may cause pneumoparotid. Infectious complications and subcutaneous emphysema are mentioned in the literature. We present a 45-year-old man with numerous episodes of distressing distension of the left parotid region. Bedside inspection is carried out and fluctuant left-sided sore parotid enlargement with crepitation at the palpation is noted. A head–neck computed tomography (CT) study with oral medium contrast is performed marking heavy emphysema of subcutaneous layer that is extension gone from temporal region to the upper thoracic outlet, also is noted an important ectasia of Stensen's duct, salivary glands, and left parotid. Medical treatment with antibiotic therapy and support measures are administrated with a complete resolution of subcutaneous emphysema. Pneumoparotid could be correlated with auto-insufflation behavior common in psychiatric conditions and some professions, it is essential besides medical treatment, a psychosocial follow-up in addition.

PDF Share
  1. Zuchi D, Da Silveira P, Cardoso C, et al. Pneumoparotitis. Braz J Otorhinolaryngol 2011;77(6):806. PMID: 22183290.
  2. McGreevy A, O'Kane A, McCaul D, et al. Pneumoparotitis: a case report. Head Neck 2013;35(2):E55–E59. DOI: 10.1002/hed.21873.
  3. Markowitz-Spence L, Brodsky L, Seidell G, et al. Self-Induced pneumoparotitis in an adolescent. Report of a case and review of the literature. Int J Pediatr Otorhinolaryngol 1987;14:113–121. DOI: 10.1016/0165-5876(87)90021-8.
  4. Ghanem M, Brown J, McGurk M. Pneumoparotitis: a diagnostic challenge. Int J Oral Maxillofac Surg 2012;41:774–776. DOI: 10.1016/j.ijom.2011.12.013.
  5. Kostantinidis I, Chatziavramidis A, Constantinidis J. Conservative management of bilateral pneumoparotitis with sialendoscopy and steroid irrigation. BMJ Case Rep 2014;2014:bcr2013201429. DOI: 10.1136/bcr-2013-201429.
  6. Birzgalis A, Curley J, Camphor I. Pneumoparotitis, subcutaneous emphysema and pleomorphic adenoma. J Laryngol Otol 1993;107(4):349–351. DOI: 10.1017/S0022215100123011.
  7. Lee K, James V, Ong G. Emergency department diagnosis of idiopathic pneumoparotitis with cervicofacial subcutaneous emphysema in a pediatric patient. Clin Pract Cases Emerg Med 2017;1(4):339–402. DOI: 10.5811/cpcem.2017.7.34879.
  8. Balasubramanian S, Srinivas S, Aparna K. Pneumoparotitis with subcutaneous emphysema. Indian Pediatr 2008;45(1):58–60. PMID: 18250510.
  9. House L, Lewis A. Pneumoparotitis. Clin Exp Emerg Med 2018;5(4):282–285. DOI: 10.15441/ceem.17.291.
  10. McCormick M, Bawa G, Shah R. Idiopathic recurrent pneumoparotitis. Am J Otolaryngol Head Neck Med Surg 2013;34(2):180–182. DOI: 10.1016/j.amjoto.2012.11.005.
  11. Prabhu S, Tran B. Pneumoparotitis. Pediatr Radiol 2008;38(10):1144. DOI: 10.1007/s00247-008-0930-x.
  12. Gazia F, Freni F, Galletti C, et al. Pneumoparotid and pneumoparotitis: a literary review. Int J Environmental Res Public Health 2020;17(11):3936. DOI: 10.3390/ijerph17113936.
  13. Lasboo A, Nemeth A, Russell E, et al. Use of the “puffed-cheek” computed tomography technique to confirm the diagnosis of pneumoparotitis. Laryngoscope 2010;120(5):967–969. DOI: 10.1002/lary.20879.
  14. Flores-Orozco EI, Tiznado-Orozco GE, Díaz-Peña R, et al. Effect of a mandibular advancement device on the upper airway in a patient with obstructive sleep apnea. J Craniofac Surg 2020;31(1):e32–e35. DOI: 10.1097/SCS.0000000000005838.
  15. Galletti B, Gazia F, Galletti C, et al. Endoscopic treatment of a periorbital fat herniation caused by spontaneous solution of continuity of the papyracea lamina. BMJ Case Rep 2019;12(4):e229376. DOI: 10.1136/bcr-2019-229376.
  16. Galletti B, Freni F, Gazia F, et al. A rare case of a huge pleomorphic adenoma of minor salivary glands in the parapharyngeal space. EuroMediterranean Biomed J 2019;14(2):7–10. DOI: 10.3269/1970-5492.2019.14.02.
  17. Ciodaro F, Mannella VK, Nicita RA, et al. Therapeutic efficacy of the Galletti-Contrino manoeuvre for benign paroxysmal positional vertigo of vertical semicircular canals in overweight subjects. Eur Arch Otorhinolaryngol 2018;275(10):2449–2455. DOI: 10.1007/s00405-018-5086-1.
  18. Nicot R, Myon L, Konopnicki S, et al. Pneumoparotid: a rare case of recurrent parotid swelling. Rev Stomatol Chir Maxillofac Chir Orale 2014;115(2):111–113. DOI: 10.1016/j.revsto.2013.03.005.
  19. Abdullayev R, Saral F, Kucukebe O, et al. Bilateral parotitis in a patient under continuous positive airway pressure treatment. Rev Brasil Anestesiol 2014;66(6):661–663. DOI: 10.1016/j.bjan.2014.05.010.
  20. Goates AJ, Lee DJ, Maley JE, et al. Parotitis as a complication of long-term oronasal positive airway pressure for sleep apnea. Head Neck 2017;00:1–4. DOI: 10.1002/hed.25003.
  21. Ambrosino R, Lan R, Romanet I, et al. Severe idiopathic Pneumoparotitis: case report and study review. Int J Pediatr Otorhinolaryngol 2019;124:196–198. DOI: 10.1016/j.ijporl.2019.07.012.
  22. Moenne K, Cordero J, Poli C. Neumoparotiditis o neumoparótida en el niño: Un diagnóstico diferencial a considerar. Rev Chil Infectivol 2009;26(6):555–559. DOI: 10.4067/S0716-10182009000700012.
  23. Alnaes M, Furevik LL. Pneumoparotitis. Tidsskr Nor Legeforen 2017;137(7):544. DOI: 10.4045/tidsskr.16.0633.
  24. Gudlaugsson O, Geirsson AJ, Benediktsdottir K. Pneumoparotitis: a new diagnositic technique and a case report. Ann Otol Rhinol Laryngol 1998;107(4):356–358. DOI: 10.1177/000348949810700416.
  25. Golz A, Joachims HZ, Neter A, et al. Pneumoparotitis: diagnosis by computed tomography. Am J Otolaryngol 1999;20(1):68–71. DOI: 10.1016/s0196-0709(99)90055-8.
  26. Curtin JJ, Ridley NTF, Cumberworth VL, et al. View from within: radiology in focus: pneumoparotitis. J Laryngol Otol 1992;106(2): 178–179. DOI: 10.1017/S0022215100119024.
  27. Meerleer KD, Hermans R. Images in clinical radiology: pneumoparotitis. JBR-BTR 2005;88:248.
  28. Kirsch DDM, Shinn J, Porzio R, et al. Pneumoparotid due to spirometry. Chest 1999;116(5):1475–1478. DOI: 10.1378/chest.116.5.1475.
  29. Chilla R, Meyforth HO, Arglebe C. Surgical treatment of chronic parotitis. Arch Otorhinolaryngol 1982;234(1):53–56. DOI: 10.1007/BF00453538.
  30. Freni F, Gazia F, Stagno D'Alcontres F, et al. Use of botulinum toxin in Frey's syndrome. Clin Case Rep 2019;7(3):482–485. DOI: 10.1002/ccr3.2019.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.