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Acute parotitis following sitting position neurosurgical procedures: review of five cases
Mustafa Berker1, Altan Sahin, Ulku Aypar
1Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Abstract:
Acute bacterial parotitis subsequent to major abdominal surgery is well documented, reportedly occurring in as many as 0.1% of patients. Postoperative parotitis has been reported between 1 to 15 weeks after surgery, commonly appearing within 2 weeks of the procedure. However, postoperative parotitis has not been reported previously after neurosurgical procedures. The authors report five cases of postoperative parotitis after neurosurgical operations in the sitting position with mild flexion and rotation of the head. This group of patients accounted for 0.16% of all craniotomy and 1.9% of all sitting position neurosurgical procedures performed in the authors' institution from 1996 through 2001. Neck flexion and head tilt in the sitting position might have an influence on acute parotitis. The authors found that the side of the parotitis was on the opposite side of the head rotation. Dehydration therapy may also be a contributing factor. The objective of this paper is to state that parotitis is a possible complication in neurosurgical patients operated on in sitting position and to discuss its pathophysiology and treatment options.
Insights
Acute bacterial parotitis is a rare complication following neurosurgery in the sitting position. This study identifies neck positioning and dehydration as potential contributing factors, highlighting parotitis as a risk for these patients.
Area of Science:
- Neurosurgery
- Surgical Complications
- Infectious Disease
Background:
- Acute bacterial parotitis is a known complication after abdominal surgery, occurring in up to 0.1% of patients.
- Postoperative parotitis typically manifests 1-15 weeks after surgery, often within the first two weeks.
- Previously, parotitis has not been documented following neurosurgical procedures.
Observation:
- This paper reports five cases of acute bacterial parotitis occurring after neurosurgical operations performed with patients in the sitting position.
- The head was positioned with mild flexion and rotation during these neurosurgical procedures.
- These cases represented 0.16% of all craniotomies and 1.9% of sitting position neurosurgeries at the institution between 1996 and 2001.
Findings:
- Neurosurgical patients in the sitting position may be at risk for developing acute parotitis.
- Neck flexion and head tilt in the sitting position are hypothesized to influence parotitis development.
- Parotitis occurred on the side opposite to the head rotation, and dehydration therapy may be a contributing factor.
Implications:
- Acute bacterial parotitis is a potential complication in neurosurgical patients undergoing procedures in the sitting position.
- Understanding the pathophysiology, including the role of neck positioning and dehydration, is crucial for prevention and management.
- This study emphasizes the need for vigilance regarding parotitis in neurosurgical patients, particularly those in the sitting position.
