Salivary Gland Disease Overview

Salivary Gland Disease

• Glands of the oral cavity: Minor salivary glands are less than 10% of the total and are located throughout the oral cavity, except for the gingiva. Major glands include parotid, submandibular, and sublingual glands. Salivary flow varies with stimuli such as taste, chewing, and medication affecting volume.

Chronic Bacterial Sialadenitis

• Characteristics: Chronic bacterial sialadenitis is often associated with chronic xerostomia and can involve submandibular and other glands. Obstruction by stones is a common cause.

Necrotizing Sialometaplasia

• Characteristics: A condition where spontaneous necrosis in the salivary gland develops, forming a deep ulcer (about 2 cm). Painless, the ulcer persists for 2 months. May resemble oral cancer initially but will heal with fibrosis, and won't recur.

Recurrent Parotitis

• Causes: Inflammation of the parotid gland, often in children, typically bilateral and painful with swelling and redness. It is often idiopathic, but may be secondary to other conditions.

Obstructive & Traumatic Lesions

• Causes: Stones, neoplasm, or fibrosis can block salivary ducts. Trauma to the parotid papilla region (opposite upper molars) can cause lesions.

Sialadenosis (Sialosis)

• Characteristics: A non-inflammatory and non-neoplastic condition often associated with systemic diseases. Characterized by a hypertrophy of glands' acini and connective tissue edema, with no damage to salivary tissue. Associated with conditions such as alcoholism, endocrine disorders (diabetes, hypothyroidism, acromegaly), pregnancy, and nutritional deficiencies. Confirmed by sialochemistry testing.

Sjogren's Syndrome

• Characteristics: An autoimmune disorder affecting salivary and lacrimal glands, resulting in dryness of the mouth (xerostomia). Common in middle-aged females. Diagnosis is confirmed based on clinical presentation and Schirmer's test, or using antibodies like RF, ANA, SS-A, or SS-B. Autoimmune response involves the cellular immunity with T-lymphocytes.

Mumps

• Characteristics: Viral infection, often in children, producing fever, malaise, and painful swelling of the salivary glands (typically bilateral) for 7-10 days. This infection can be resolved spontaneously and is preceded by a MMR vaccine (commonly associated).

Acute Bacterial Sialadenitis

• Causes: Usually caused by bacterial infection, typically Staphylococcus or Streptococcus or mixed; characterized by rapid swelling, redness, pain, fever, and leukocytosis. Ascending infections through the glands are also possible and uncommon forms.

Sialolithiasis (Stones in Salivary Glands)

• Characteristics: Stones in salivary glands are common, frequently in the submandibular gland due to ductal structure (tortuous and long). Common symptoms: pain, swelling, pus discharge. Treatment options may include removing stones.

Radiation Induced Sialadenitis

• Characteristics: Radiation therapy for head and neck cancers can damage salivary glands. This usually results in acute xerostomia or irreversible fibrosis & squamous metaplasia.

Salivary Gland Biopsy

• Reasons: A biopsy is often avoided for a salivary gland to reduce the chance of introducing infection. Sialography may also be avoided under certain circumstances.

Imaging and Diagnostic Techniques

• Salivary scintigraphy: Uses technetium-99m pertechnetate to visualize the salivary glands and identify functional abnormalities. Other imaging techniques and serological tests including antibodies, blood count analysis, and other diagnostic testing techniques are important parts of the diagnostic process.

Explore various conditions affecting the salivary glands, including minor and major glands, chronic bacterial sialadenitis, necrotizing sialometaplasia, and recurrent parotitis. Learn about their characteristics, causes, and symptoms in this comprehensive quiz.