PAROTITIS

PAROTITIS

• Parotitis refers to inflammation of the parotid gland, which is the largest of the salivary glands.

• It may be acute or chronic, infectious or non-infectious in nature.

• In Ayurveda, the condition can be correlated to diseases like "Kapha-Sthana-Gata Shotha", "Vataja Shotha", or "Arbuda", depending on the clinical presentation.

ANATOMICAL LOCATION AND STRUCTURE OF PAROTID GLAND

• The parotid gland is situated below and in front of the external ear, extending to the mandibular ramus and masseter muscle.

• The gland is enclosed in a tough capsule and its duct (Stensen’s duct) opens into the oral cavity near the second upper molar.

ETIOLOGY (NIDANA)

AYURVEDIC VIEW

• Nidana (causative factors) include:

  • Viruddha ahara (incompatible food)

  • Dushita Kapha or Rakta

  • Ama dosha

  • Agantuja nidana (external factors like trauma or infection)

MODERN VIEW

• Viral infection (commonly by mumps virus – Paramyxovirus)

• Bacterial infection (especially Staphylococcus aureus)

• Obstruction of the parotid duct (due to stone or tumor)

• Poor oral hygiene or dehydration

• Autoimmune diseases like Sjogren’s syndrome

SAMPRAPTI (PATHOGENESIS)

• In Ayurveda, inflammation is caused due to vitiation of doshas, mainly Kapha and Rakta, leading to shotha (swelling) in the Kapha sthana (head and neck region).

🔸 शोथश्च त्रिविधः प्रोक्तः समः निर्घातसम्भवः।
पित्तश्लेष्माश्रयो रक्तश्च त्रयाणां च प्रवृत्तितः॥
— Aṣṭāṅgahṛdaya Nidānasthāna 12/1

LAKSHANA (CLINICAL FEATURES)

AYURVEDIC FEATURES

• Shotha (Swelling) near the jaw or ear

• Ruja (Pain), especially on chewing or speaking

• Daurgandhya (foul smell) from mouth

• Jwara (Fever)

• Stambha (Stiffness) in the region

• Mukhapaka (oral ulcers)

MODERN FEATURES

• Painful swelling in the preauricular region

• Dry mouth or difficulty opening the mouth

• Fever, malaise, headache

• Purulent discharge from Stensen’s duct in bacterial cases

• Bilateral swelling common in viral (mumps) parotitis

UPADRAVA (COMPLICATIONS)

AYURVEDIC VIEW

• Granthi (cystic swelling)

• Vidradhi (abscess formation)

• Arbuda (tumor-like swelling)

MODERN VIEW

• Parotid abscess

• Facial nerve palsy (if infection spreads)

• Chronic sialadenitis

• Parotid fistula

• Dehydration and electrolyte imbalance (in children with mumps)

PARIKSHA (DIAGNOSIS)

AYURVEDIC METHODS

• Darshana (Inspection) – Assess swelling and pus discharge

• Sparshana (Palpation) – To check consistency, warmth, tenderness

• Prashna (Interrogation) – History of fever, appetite, salivation

MODERN METHODS

• Clinical examination of swelling and oral cavity

• Culture of ductal discharge

• Ultrasound/CT Scan – to assess gland size, abscess or stone

• Serology – mumps IgM/IgG antibodies

• Sialography – in chronic or recurrent cases

CHIKITSA (TREATMENT)

AYURVEDIC TREATMENT

SHODHANA CHIKITSA

• If Ama or Dosha vitiation is prominent:

  • Mridu Virechana (mild purgation)

  • Nasya Karma with Tikta-Kashaya drugs

  • Raktamokshana in localized swelling

SHAMANA CHIKITSA

• Gandhaka Rasayana

• Kaishora Guggulu

• Punarnavadi Kashaya

• Dashamoola Kwatha

• Lepa with Haridra, Triphala, Guggulu

🔸 शोफे हितानि चूर्णानि चूर्णानां च प्रशमनम्।
लपनं सेक एवाथ विद्यादौषधसम्भवम्॥
— Suśruta Saṃhitā Cikitsāsthāna 1/86

BAHYA CHIKITSA

• Lepa (paste) of Haridra, Guggulu, and Eranda

• Swedana (fomentation) to reduce stiffness and pain

MODERN TREATMENT

ACUTE BACTERIAL PAROTITIS

• Antibiotics – Amoxicillin + Clavulanic acid, Clindamycin

• Analgesics – NSAIDs for pain and inflammation

• Hydration therapy

• Warm compresses and massage towards duct

• Surgical drainage in case of abscess

VIRAL PAROTITIS (MUMPS)

• Symptomatic management:

  • Paracetamol, hydration, rest

  • Isolation for 5-7 days to prevent transmission

CHRONIC PAROTITIS

• Treatment of underlying cause (stone, autoimmune, dental infection)

• Sialogogues to stimulate salivary flow

• In recurrent cases, parotidectomy may be considered

PROGNOSIS (SADHYA-ASADHYA)

• Sadhya in uncomplicated acute viral parotitis

• Krichra sadhya if suppuration or abscess occurs

• Asadhya if malignant transformation or repeated chronic infection sets in

PREVENTION

• Immunization with MMR vaccine (Measles, Mumps, Rubella)

• Maintain good oral hygiene

• Avoid dehydration

• Prompt treatment of oral infections and ductal obstructions