Commentary “Postoperative Acute Sialadenitis after Skull Base Surgery”

The authors have compiled a compelling case series of acute sialadenitis after neurosurgical procedures associated with significant head rotation. The article appears to be the first reported association between acute sialadenitis and neurosurgical positioning. The five cases described all involve the extreme head rotation required by retrosigmoid and far-lateral approaches. Kim et al offer a thorough review of the diagnosis and treatment for this clinical entity as well as a proposed mechanism for the complication.

This report is particularly useful for neurosurgeons who, while performing the bulk of retrosigmoid and far-lateral cranial procedures, might be less familiar with the recognition and treatment of acute sialadenitis. Such a seemingly rare and minor complication might have drastic implications if airway patency is compromised in the immediate postoperative period. Awareness of this clinical entity is important for all surgeons who must access the skull base using extreme head rotations.