Introduction
Swelling or pain in the parotid region is a relatively common complaint in clinical practice of internal medicine, otolaryngology, and oral and maxillofacial surgery. There are many causes of parotid gland swelling, such as inflammation, viral infection, sialoliths, benign or malignant tumors, autoimmune diseases, and endocrine disorders. The pneumoparotid is one of the causes of parotid gland swelling, which refers to the retrograde insufflation of air inside the parotid gland or Stensen’s duct. The pneumoparotid was first described by Hyrtl1in 1865 in wind instrument players. Moreover, until the first half of the 20th century, the pneumoparotid has been recognized as a typical occupational disease in glass blowers.2-4 However, the other etiologies of the pneumoparotid are variable and include self-induction, 5-11 abnormal habit,12-14 coughing attack,15-17nervous tic,5, 18, 19 iatrogenic causes such as dental treatment,19-21 continuous positive pressure23, 24 and spirometry.25
Obstructive sleep apnea is a disorder characterized by repetitive, complete, or partial closure of the upper airway during sleep.26 Sleep apnea is defined as 30 or more apneic episodes (cessation of airflow at the mouth and nose for more than 10 s).26-29 Typical subjective complaints of sleep apnea are excessive daytime sleepiness, loud and irregular snoring, disturbed nighttime sleep, mental deterioration and depression.30, 31 A recent systematic review highlighted that the overall prevalence of obstructive sleep apnea ranged from 9% to 38% in the general adult population.32 Patients with this condition are at an increased risk of automobile accidents.33, 34 It is associated with an increased prevalence of cardiovascular complications, such as arterial hypertension,35, 36 coronary artery disease,37 and nocturnal angina.38
Continuous positive airway pressure is an effective treatment option. However, problems associated with its use leading to non-compliance include nasal congestion, discomfort secondary to pressure sensation and air leak, and mask intolerance.30, 31 In 1984, Meier-Ewert et al.39 first described an oral appliance for obstructive sleep apnea syndrome. Oral appliances are an important treatment choice and may be the preferred initial treatment for mild to moderate obstructive sleep apnea syndrome or snoring.
In this study, we describe a patient with pneumoparotid disease related to obstructive sleep apnea syndrome and oral appliance therapy. Plausible relationship between pneumoparotid and sleep apnea syndrome is discussed.