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Acute unilateral parotid glands enlargement following endotracheal general anesthesia: report of two cases.

Acute parotid gland enlargement in association with general anesthesia is rare and has also been called anesthesia mumps. We present two patients who were scheduled for lumbar spine surgery under general anesthesia. Each developed acute unilateral parotid gland enlargement over one side of the face proven by sonography. Case 1: A 52-year-old man was scheduled for his third lumbar spine to first sacral spine surgery for scoliosis and spondylolisthesis. The patient was provided general anesthesia with oral endotracheal intubation and placed in the prone position with the neck flexed at approximately 10 degrees. The head was turned to the left side and the right side of the face was placed on a soft gel rolling pad. After 6 hours of surgery, swelling of the right parotid gland was noted upon endotracheal extubation. Twenty four hours later, the patient received sonographic examination of the salivary gland which showed dilatation of the right parotid duct with obstructive inflammation. After receiving non-steroidal anti-inflammatory drug (NSAID) treatment, his symptoms and signs subsided 2 weeks after the surgery. Case 2: A 53-year-old woman was scheduled for her third lumbar spine to fifth lumbar spine instrumentation and internal fixations for spondylolisthesis. A similar anesthetic regimen and surgical position was provided as with Case 1. The duration of the surgery was about 5 hours and swelling of the right parotid gland was also noted postoperatively. Sonographic examination of the salivary gland showed only an inflammatory process without dilatation of the parotid duct. She had complete recovery of the condition 10 days after surgery. There were no complications nor residual enlargement of the parotid gland in either of our two patients after conservative treatment.