Parotid

1. Dr.Shyam Sunder Reddy(P.G)
Under guidance of unit chief:Dr.N.V.N.Reddy
Associate professor:Dr.Latchu
Assistant professor:Dr.Manjusha
Assistant professor:Dr.Devender

2. PAROTID SWELLING

3. A 45 years old female,resident of nalgonda district,labour by occupation,
Presented with chief complaints of
.Swelling infront and below the left ear lobule since 4 years

4. History of present illness
Patient was apparently asymptomatic 4 years back,later she developed swelling in front
and below the left ear lobule,insidious in onset which was initially peanut in size and
has gradually progressed to present size
No h/o pain over the swelling.
No h/o variation in size while chewing food
No h/o purulent discharge from mouth
No h/o assymetry of face
No h/o difficulty in closing in eyes
No h/o difficulty in chewing food
No h/o drooling of saliva
No h/o any other swelling in the neck
No h/o loss of apetite and weight

5. PAST HISTORY
.No comorbid illness or any autoimmune disorders.
.No h/o mumps.
.No past history of surgery in the same region.

6. PERSONAL HISTORY
.Sleep and appetite are normal
.Bladder and bowel habits are normal
.Non smoker and non alcoholic.
FAMILY HISTORY
No history of similar swellings or cancers in the family

7. SUMMARY OF THE HISTORY
A 45 old female with no known comorbidities presented with complaints of a painless
,gradually progressive swelling in front of and below the left ear lobule since 4 years with
no other associated symptoms and no history of features suggestive of facial nerve palsy.

8. GENERAL EXAMINATION
The patient was examined in sitting position in a well lit room after obtaining informed
consent.
Patient is conscious,coherent and cooperative
Moderately built and nourished
No pallor,icterus,cyanosis,clubbing,generalized lyphadenopathy and pedal edema
VITALS
Afebrile
PR;81/min with normal volume ,normal rythm
BP;110/70mmhg in right arm supine position
RR;14/min

9. INSPECTION
A swelling of size 8*7 cm noted in the
left parotid region just in front and
below the left ear lobule displacing it
upwards and outwards.
The swelling is obliterating the groove
between the ramus of mandible and
mastoid process.
The surface appears smooth,borders are
well defined
The skin overlying the swelling is normal

10. No other swelling noted in the neck
Facial symmetry appears normal
Mouth opening normal
Oral hygiene maintained
Uvula central and no Medial displacement of left tonsilllar fossa

11. PALPATION
All inspectory findings were confirmed
No local rise of temperature and tenderness
A solitary swelling of size 8*7 cm noted in left parotid region ,with lobulated
surface,well defined margins,firm in consistency and mobile.
Not able to move the swelling above the zygomatic arch.
The swelling is not fixed to underlying masseter or overlying skin
Swelling not palpable bimanually

12. Parotid duct opening normal with no pus/blood discharge on pressing parotid gland
Parotid duct bidigitally palpable with no impacted stones within
Examination of facial nerve normal
No enlarged cevical lymphnodes
Temperomandibular joint normal
Contralateral parotid gland not palpable
Cervical spine and scalp normal

13. RESPIRATORY SYSTEM
.normal vesicular breath sounds heard
.no adventitious sounds
CVS
.s1,s2 heard
No murmurs
CNS
Reflexes normal
No focal neurological deficits
PER ABDOMEN
Soft,no organomegaly
Bowel sounds present

14. CASE SUMMARY
A 45year old femlae presented with complaints of swelling in left parotid region
associated with no other symptoms
On examination
A solitary swelling of size 8*7 cm noted in left parotid region ,with lobulated surface,well
defined margins,firm in consistency and mobile,with no cervical lymphadenopathy and
signs of facial nerve palsy.

15. PROVISIONAL DIAGNOSIS
Left benign parotid tumour most likely pleomorphic adenoma