Parotid Gland Examination

Parotid Gland

INSPECTION
Swelling : Site - below , behind , slightly infront of lobule of ears
Extention - up - pushing ear lobe upward
down - each to upper part of neck
posterior - upper part of postrior triangle
anterior - mandible
Angle of mandible can't seen or normally seen
Size
shape
surface - nodular and if there is fistula , ulcer, sinus ornot
Scar - with stitches ( superficial parotidectomy scar ပဲ ျဖစ္ေလ့ရွိ )
ညီ ညာ ၇င္ biopsy ယူ ထား တာ ။
triangle ဆို ရင္ ဗမာ ေဆး ဆ၇ာ လက္ ခ်က္ျဖစ္ေလ့ရွိ ၊။

Oral cavity : dumb-bell tumour (+/-) ( အျပင္ ၁ ခု . အ တြင္း ၁ ခု )
parotid duct opening ( + / -) and stone presentor not
internal opening describe လုပ္ ပါ ။

Face : facial palcy ( + /- )

Temporal mendibular joint : ပါးစပ္ဟပါအံုး - ဟႏိုင္ရင္ - no malignant involvement of joint


PALPATION : Temparature
Tenderness
site
size
shape
surface
Consistancy - hard ( if cystic test fluctation test and transilluminatin test )
Fixity - skin involvement- if scar present , attachment present as usually )
masseter muscle involvement - လက္နဲ ့ စမ္း
အံက်ိတ္ခိုင္းၿပီး လက္နဲ ့ စမ္း
လွုပ္ လို ့ မ ရ ရင္ fixity present

Others : other parotid gland examination - inspection and palpation
Cervical lymph nodes palpation


Diagnosis : Parotid gland probably due to pleomorphic adenoma

Differential diagnosis : Pleomorphic adenoma
secondary lymph node

Investigation : fine needle aspiration cytology
Excisional biopsy
Treatment : If adenoma ,Superficial Parotidectomy .
If cancer , total conservative parotidectomy ( if small and mobile )
, radical parotidectomy and facial nerve grafting with great auricular nerve
, radiology ( if large and fix )
If lymph node , enbloc removal (if mobile )
, radiology ( if fix )