Overview of the Parotid Gland

Acute pain in a throat at the young women.
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The parotid glands are one of the three major types of salivary glands in the body, and are probably most recognized by those who lived before the mumps vaccine was available. Mumps was a common childhood infection characterized by the "chipmunk cheeks" of swollen parotid glands. These glands are present on each side of your face and secrete saliva to aid in digestion. Let's look at the anatomy and function of the parotid gland, as well as common diseases that affect this gland.

Anatomy of the Parotid Gland

You have two parotid glands, each one located in front of the ear on your face. In addition to the parotid gland, you also have two other major salivary glands, called the sublingual and submandibular glands. All three glands have a tube attached to them, called a duct, that transports saliva from the gland to the mouth. The duct that drains the parotid gland is called Wharton's duct.

The Function of the Parotid Gland

The function of the parotid gland and other two major salivary glands is to produce and secrete saliva, a substance that helps break food down so it can be digested properly. Saliva also helps to defend against bacteria and prevent cavities.

Diseases of the Parotid Gland

There are several types of medical conditions which can affect the salivary gland, from stones to tumors. Let's look at each of these separately.

Xerostomia (Dry Mouth)

When a person's salivary glands do not function properly and stop or produce too little saliva, a person will develop a dry mouth — this is called xerostomia. There are a number of potential causes for xerostomia including radiation therapy, an autoimmune disease called Sjogren's syndrome, or medications like antihistamines or chemotherapy. Dry mouth can significantly impact a person's quality of life. It can affect swallowing, create a burning feeling in the mouth, and predispose a person to cavities. Treatment includes artificial saliva and medications that stimulate saliva production.

Sialadenitis (Bacterial Infection of the Parotid Gland)

Sialadenitis is a bacterial infection that can affect the parotid gland as well as the submandibular gland. It most often arises after slowed drainage from the gland (a partial obstruction) results in a secondary infection in the gland. Symptoms may include tenderness of the cheek, fever, swelling, pain with eating, and sometimes the presence of pus is noted at the opening of the duct in the mouth. It most commonly occurs in people with a chronic illness, or in a person who becomes dehydrated.

Treatment includes antibiotics and warm compresses to the gland. Some providers recommend massage of the parotid gland, but this can be painful. Sucking on lozenges or cough drops may stimulate the flow of saliva and help clear the infection. If the infection isn't promptly treated, an abscess may form, which may require drainage.

There is also a chronic form of sialadenitis that is usually related to an obstruction rather than a bacterial infection.

Sialolithiasis (Obstruction of the Parotid Gland)

Another potential parotid gland ailment, sialolithiasis, is an obstruction, which usually occurs when a stone (a calculus) blocks the tube (Wharton's duct) that carries saliva to the mouth. Obstruction causes pain and swelling on the side of the face of the affected gland. Not drinking enough fluids or taking a medication that reduces the amount of saliva production can trigger a stone formation.

If the obstruction is due to a stone, initial treatment may include drinking lots of fluids, massaging the gland, and sucking on a lemon drop or vitamin C lozenge to trigger saliva production. If this does not work, a doctor can use an instrument to remove the stone.

Stones close to the opening (on the floor of the mouth) can sometimes be removed through the mouth. Stones that lie deeper in the duct are more challenging to treat, as using instruments in this region could damage a nerve. Treatments similar to those for kidney stones, such as corporeal shock-wave lithotripsy, or fluoroscopic basket retrieval may be effective.

If stones are chronic and severe, the parotid gland itself may need to be removed, but this is not done if at all possible.

Other less common causes of obstruction in the parotid gland include:

  • A person's dentures compressing the duct opening
  • Tooth eruption as a result of trauma
  • Mucous plugs or foreign bodies that get into the duct
  • A neoplasm (tumor) or a swollen lymph node that blocks the duct

Inflammatory/Infiltrative Disorders of the Parotid Gland

There are several types of medical disorders which may result in enlargement of the parotid gland, either by infiltrating the gland or by causing inflammation in the gland These include:

  • Sjogren syndrome
  • Sarcoidosis
  • Alcoholism 
  • Diabetes
  • HIV/AIDS
  • Drug-induced (some medications can make saliva thicker, such as iodine)

Mumps (Viral) Infection and the Parotid Gland

The most common viral infection salivary gland is mumps, which causes enlargement of both parotid glands. Prior to the introduction of the vaccine in 1967, mumps was a very common childhood infection, characterized by "chipmunk cheeks." Outbreaks still occur occasionally, but it is a rarity now relative to in the past. If you have symptoms of mumps, it is important to see a doctor for accurate diagnosis and treatment.

Tumors of the Parotid Gland

The parotid gland can also develop growths or masses, called tumors. These tumors are often benign rather than malignant (cancerous). In contrast, tumors of the other major salivary glands, as well as the minor salivary glands, are often malignant. Malignant parotid tumors are usually either mucoepidermoid and adenocystic carcinomas, or adenocarcinomas.

What to Do If You Are Concerned by your Parotid Gland

If you notice swelling or tenderness over your parotid gland, talk to your doctor. Not only could your discomfort signal an infection or stone which should be treated, but a swollen parotid gland might also indicate an underlying disease process. When you see you primary care doctor she may refer you to an ear, nose, and throat doctor (ENT) for further evaluation.

Bottom Line on the Parotid Glands

The parotid glands on each side of your face perform an important function in creating saliva, which in turn aids in digestion, lubricates your mouth, and inhibits dental decay. Infections and stones in the parotid glands may require treatment, and swelling of the parotid glands may provide important clues as to the presence of other medical concerns as well.

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Article Sources
  • American Academy of Otolaryngology-Head and Neck Surgery. Salivary Glands. http://www.entnet.org/content/salivary-glands
  • Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw Hill education, 2015. Print.