A small bursa may develop between the parotid fascia (parotideomasseteric fascia) and the masseter muscle, or between the parotid gland tail and the overlying skin, in response to chronic direct pressure or repeated parotid swelling and contraction. It is an adventitial structure rather than a consistent anatomical bursa.
Parotid region bursitis is a rare and often misdiagnosed cause of pre-auricular and parotid region swelling that mimics parotid gland pathology. It presents as a soft compressible fluctuant pre-auricular swelling without systemic features of parotitis. Ultrasound demonstrates a simple fluid collection external to the parotid gland capsule. It must be distinguished from parotid tumours, parotid cysts, first branchial cleft cysts, and preauricular lymph node enlargement before aspiration.
A small adventitial bursa anterior to the ear in the parotideomasseteric region mimics a parotid superficial lobe mass on clinical examination, distinguished by ultrasound showing an extra-glandular fluid collection external to the parotid capsule, managed by aspiration and corticosteroid injection.
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