Objective: To propose a practical and reasonable classification of chronic suppurative parotitis (CSP) on the basis of the various entities.
Material and methods: Clinical, laboratory, sialographic, scintigraphic, histopathologic (including ultrastructural) study of recurrent parotid swellings (RPS) was performed in 291 patients over a 10-year period.
Results: It is suggested that CSP should be classified into recurrent parotitis in childhood (RPC), recurrent parotitis in adults (RPA), chronic obstructive parotitis (COP) and should be differentiated from other subdivisions including subclinical Sjögren's syndrome (SCSS), chronic parotid swelling of Sjögren's syndrome and sialadenosis with retrograde infection. RPA is a continuation of recurrent parotid swelling from childhood (RPC) to adulthood. Remission can take place spontaneously 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 convenient and practical method with a definite effect. SCSS is an autoimmune disease and should be treated as systemic disease.
Conclusions: Because there exists confusion in the nomenclature of RPS this revised classification is based on the various entities and can be used as a guide in the diagnosis and treatment of RPS.