gms | German Medical Science

Objective: Acute postoperative sialadenitis, also known as anaesthesia mumps, is a rare complication after general anaesthesia for surgical procedures. This is a report of a patient that presented with anesthesia mumps after craniotomy for the resection of a parasagittal meningioma.

Methods: The 42-year-old male patient was submitted to a right frontal parasagittal craniotomy for the resection of a right parasagittal parafalcine meningioma under general anaesthesia. After the procedure, he was extubated and he was transferred to the internal care unit for postoperative observation and care. Nine hours after the end of the operation, he presented with acute bilateral neck swelling and a subjective feeling of dyspnea. The neck computer tomography scan revealed a bilateral edema of the parotid and submandibular salivary glands, mainly on the left side, and the structures around the pharynx and the larynx, representing a threat for the airway.

Results: The neck swelling gradually subsided under conservative treatment, without the need to reintubate the patient. Unable to swallow for the first few days, he gradually regained the control of his swallowing mechanism, led by a team of head and neck surgeons and speech and language therapists. During his postoperative course, he developed an exacerbation of his preoperative psychiatric findings that ameliorated with the appropriate anti-psychotic regimen. The patient was discharged without neurological deficits.

Conclusion: Acute sialadenitis is a rare postoperative condition that may complicate the craniotomy for the resection of an intracranial lesion. Although infrequent, benign and self-dissolving, it may occasionally represent a threat for the airway. Therefore, the neurosurgeon and other involved clinicians should be aware of this disorder, its course, its treatment and the indications for intubation. The treatment of this rare condition is best achieved in the context of a properly organized multidisciplinary team.