Parotid tuberculosis

Twenty-nine cases of tuberculosis of the parotid region were divided into two groups of TB (clinically superficial and clinically deep) according to etiology, clinical manifestation and diagnostic-therapeutic approach. The less numerous group (11 cases) was that of the "clinically deep" TB which did not present any peculiarities which differentiate it from the most common tumors (pleomorphus adenoma) and from chronic inflammation (aspecific sialoadenitis). This form of TB affects middle-aged and elderly people and most probably has a post-primary etiopathogenesis. Due to the difficulty in pre-operative diagnosis (symptoms are aspecific) treatment is generally surgical (total parotidectomy conserving the facial nerve). From a histological point of view this group manifests primary lymph node involvement (9 lymphadenitis/11 cases) or glandular involvement (2 parotitis/11 cases). On the contrary, the "clinically superficial" forms except for lymph node involvement, the "clinically superficial" (18 cases) with exclusive lymph node involvement did not present any difficulties in diagnosis. This forms are found in youth (average 23) and frequently show simultaneous involvement of the cervical lymph nodes (11 cases/18) and strong tendency towards colliquation and fistulation (8 cases/18). Diagnosis is rather easy. On the one hand it is bases on clinical characteristics and, on the other, on biopsy and needle biopsy. The characteristics of the superficial forms of TB do not seem to differ much from those of cervical TB, neither in terms of appearance nor, most probably, in terms of etiopathogenesis. Therefore, they are for the most part primary forms. The authors describe the clinical manifestation, the diagnostic problems and results of the therapy performed. The importance of early diagnosis is emphasized. Pre-operative recognition of the tubercular nature of the lesion makes it possible to adopt a drug therapy promptly. One or more cycles of antitubercular drugs are almost always able to cure the pathology in question.