CHRONIC SUPPURATIVE PAROTITIS - A PROPOSED CLASSIFICATION

Objective, To propose a practical and reasonable classification of chr onic suppurative parotitis (CSP) on the basis of the various entities. Material and Methods, Clinical, laboratory, sialographic, scintigraph ic, histopathologic (including ultrastructural) study of recurrent par otid swellings (RPS) was performed in 291 patients over a 10-year peri od: Results, It is suggested that CSP should be classified into recurr ent parotitis in childhood (RPC), recurrent parotitis in adults (RPA), chronic obstructive parotitis (COP) and should be differentiated from other subdivisions including subclinical Sjogren's syndrome (SCSS), c hronic parotid swelling of Sjogren's syndrome and sialadenosis with re trograde infection. RPA is a continuation of recurrent parotid swellin g from childhood (RPC) to adulthood. Remission can take place spontane ously in RPC and RPA so that self-conservative therapy is mainly used for reducing the parotid swellings. COP is recurrent parotid swellings and/or purulent discharge resulting from various obstructive factors. Mild COP can recover completely with the use of conservative methods, severe COP is often resistant to conservative treatment and should be treated with surgical modality or injection of methyl violet into the diseased gland. Treatment with methyl violet is considered as a conve nient and practical method with a definite effect. SCSS is an autoimmu ne disease and should be treated as systemic disease. Conclusions. Bec ause there exists confusion in the nomenclature of RPS this revised cl assification is based on the various entities and can be used as a gui de in the diagnosis and treatment of RPS.