Conservative management of self-induced pneumoparotid in a 46-year-old male: A case report

Pneumoparotid is a rare cause of parotid gland swelling characterized by the presence of air within Stensen's duct and/or the parotid gland itself. It is often confused with more common causes of parotid enlargement, such as infection, and may be self-induced or associated with increased intraoral pressure. Awareness of this entity is important to avoid misdiagnosis and inappropriate treatment. We report an adult case of self-induced pneumoparotid in a 46-year-old male who developed recurrent bilateral parotid swelling over several months due to intentional oral auto-insufflation performed to relieve temporomandibular joint discomfort and anxiety. On otolaryngology evaluation, he had mild, soft, non-erythematous parotid swelling with subtle crepitus over the left gland. Computed tomography of the head and neck demonstrated air within both Stensen's ducts, the parotid parenchyma, and the overlying facial subcutaneous tissues, with no signs of inflammation or abscess. The patient was afebrile and without leukocytosis, and a diagnosis of self-induced pneumoparotid was established. He was managed conservatively with counseling to discontinue the pressure-generating maneuvers, and no procedural intervention was required. The swelling resolved with behavior modification, and he remained free of recurrence over 3 months. This case highlights pneumoparotid as an important differential diagnosis for recurrent, noninfectious parotid swelling and demonstrates that early recognition combined with targeted history-taking and conservative management can prevent unnecessary invasive treatments and serious complications, even in adult patients.