Salivary Gland Diseases and Functions

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Questions and Answers

In Sjogren's disease, which of the following is NOT a common manifestation?

Dryness of the eye

Rheumatoid arthritis

Hypertension (correct)

Dryness of the mouth

What is the suspected cause of Sjogren's disease?

HIV

Cytomegalovirus (correct)

Hepatitis B

Human papillomavirus

What is the risk of lymphoma development in patients with Sjogren's disease?

10 times higher than the general population

20 times higher than the general population

50 times higher than the general population

44 times higher than the general population (correct)

What is the characteristic feature of benign lymphoepithelial lesions?

Progressive lymphocytic infiltration and diffuse enlargement of the salivary glands Signup and view all the answers

What is the purpose of lip biopsy in diagnosing autoimmune salivary diseases?

To examine the minor salivary glands Signup and view all the answers

What is the treatment for dry eyes in patients with Sjogren's disease?

Instillation of artificial tears made up of methylcellulose Signup and view all the answers

What should be performed if a patient with Sjogren's disease develops a palpable mass in the parotid?

Needle biopsy Signup and view all the answers

What is the complication of autoimmune salivary diseases that occurs in 20% of cases?

Lymphoma Signup and view all the answers

What is the primary cause of salivary stone formation in the submandibular gland?

Viscous saliva with high calcium concentration Signup and view all the answers

What is the complication of injuring the mandibular branch of the facial nerve during submandibular sialadenectomy?

Drop of the angle of the mouth and deviation towards the normal side Signup and view all the answers

What is the radiographic feature of a salivary stone in the submandibular gland?

80% of cases are radio-opaque Signup and view all the answers

What is the treatment for a stone that resides in the submandibular gland?

Surgical removal of the submandibular gland Signup and view all the answers

What is the clinical feature of salivary stones?

Painful gland swelling during eating Signup and view all the answers

What is the function of salivary amylase in the mouth?

To break down starch into simple sugars Signup and view all the answers

What is the complication of injuring the lingual nerve during submandibular sialadenectomy?

Loss of sensation of the anterior 2/3 of the tongue Signup and view all the answers

What is the term used to describe the salivary gland's analogue of bronchiectasis?

Sialectasis Signup and view all the answers

What is the investigation of choice for detecting salivary stones?

Plain occlusal view radiograph Signup and view all the answers

What is the usual location of parotid gland fistula related to the gland?

Lower pole of parotid Signup and view all the answers

What is the incidence of submandibular stone formation compared to the parotid and sublingual glands?

Higher than the parotid and sublingual glands Signup and view all the answers

What is the usual presentation of mumps in children?

Bilateral painful parotid gland swelling with fever Signup and view all the answers

Which nerve is avulsed to treat parotid gland fistula?

Auriculotemporal nerve Signup and view all the answers

What is the most common organism responsible for acute suppurative sialadenitis?

Staphylococcus aureus Signup and view all the answers

What is a predisposing factor for acute suppurative sialadenitis?

Obstruction of salivary duct by food particles Signup and view all the answers

What is the incidence of salivary neoplasms in head and neck tumors?

5% of head and neck tumors Signup and view all the answers

What percentage of parotid neoplasms are malignant?

25% of parotid neoplasms Signup and view all the answers

What is the route of entry of the organism in acute suppurative sialadenitis?

Both through the duct from the mouth and through the blood Signup and view all the answers

What is the most common salivary gland involved in acute suppurative sialadenitis?

Parotid gland Signup and view all the answers

What is the most common type of benign tumor in salivary neoplasms?

Pleomorphic adenoma Signup and view all the answers

What is the treatment for acute attacks of infection in sialectasis?

Antibiotics Signup and view all the answers

What is the treatment for parotid duct fistula when the fistula is affecting the distal 2 cm of the duct?

Rectangular pedicle flap of mucosa from the inner aspect of the cheek Signup and view all the answers

What is the percentage of salivary neoplasms that arise in the parotid gland?

80% of salivary neoplasms Signup and view all the answers

What is the percentage of salivary neoplasms that are benign?

80% of salivary neoplasms Signup and view all the answers

What is the primary cause of nerve weakness in parotid surgery, even if the facial nerve is preserved?

Neurapraxia due to nerve damage Signup and view all the answers

Where are the majority of tumors in the parotid gland typically located in relation to the facial nerve?

Superficial to the facial nerve Signup and view all the answers

Which of the following nerves is NOT at risk of injury during submandibular sialadenectomy?

Vagus nerve Signup and view all the answers

What is the most common cause of submandibular sialadenectomy?

Stone in the submandibular gland Signup and view all the answers

What is the recommended approach for treating low-grade mucoepidermoid carcinoma?

Attempt to preserve the facial nerve Signup and view all the answers

What is the treatment approach for tumors that are clinically malignant?

Modified treatment according to the aggressiveness of the tumor Signup and view all the answers

What is the characteristic of a swelling in the parotid region that arises from the masseter muscle?

It becomes fixed on muscle contraction Signup and view all the answers

What is the name of the syndrome that may follow surgery in the region of the parotid gland?

Frey's syndrome Signup and view all the answers

Study Notes

Salivary Glands and Associated Diseases

Salivary glands produce saliva, which mediates taste sensation, and aids in starch digestion by salivary amylase.
Salivary glands also have antimicrobial properties and maintain tooth integrity.

Non-Neoplastic Salivary Gland Diseases

Congenital diseases: aplasia, ectopic parotid tissue, cystic hygroma, and sialectasis.
- Sialectasis: characterized by degeneration of alveolar and duct systems, leading to dilation and infection.
Infections: viral parotitis, acute bacterial sialadenitis, recurrent subacute and chronic sialadenitis.
- Viral parotitis: mumps, a common cause of salivary gland swelling.
- Acute bacterial sialadenitis: caused by Staphylococcus aureus, Streptococci, and Pneumococci, predisposed by poor oral hygiene, obstruction, dehydration, and debility.
Salivary stones (sialolithiasis): form from saliva constituents, may cause or result from chronic and recurrent sialadenitis, and complicate Sjogren's syndrome.
- Pathology: stones may reside in the gland or duct, causing painful gland swelling and blockage of salivary ducts.
- Clinical features: painful gland swelling while eating, acute or recurrent attacks of sialadenitis.
- Investigations: plain occlusal view radiograph, ultrasound.
- Treatment: surgical removal of the stone, either through the mouth or with gland removal.
Autoimmune salivary diseases: Sjogren's disease and benign lymphoepithelial lesions.
- Sjogren's disease: characterized by dryness of the mouth and eyes, and rheumatoid arthritis, caused by a cytomegalovirus affecting the ducts of the salivary glands.
- Benign lymphoepithelial lesions: progressive lymphocytic infiltration and diffuse enlargement of the salivary glands, particularly the submandibular and parotid glands.
Complications: 20% of cases develop lymphomas, and patients with Sjogren's disease are 44 times more prone to developing lymphoma.
Diagnosis: lip biopsy, parotid sialography.
Treatment: artificial tears, meticulous oral hygiene, and needle biopsy.

Parotid Salivary Fistula

May be connected to the duct or gland.
Fistula related to the gland is usually related to the lower pole of the parotid.
Salivary discharge is increased by meals and sucking of a lemon.
Treatment: atropine derivatives, irradiation, avulsion of the auriculo-temporal nerve, excision of the fistula, and conservative superficial parotidectomy.

Salivary Neoplasms

Incidence: 1.2% of all neoplasms, 5% of head and neck tumors.
The majority of salivary neoplasms are benign and arise in the parotid gland.
Rule of 80%: 80% of salivary neoplasms arise in the parotid gland, 80% affect the superficial lobe, and 80% are benign.
Pathology: the majority of tumors arise in the parotid gland, and most are benign pleomorphic adenomas.
Treatment: modified according to the aggressiveness of the tumor.

Swellings in the Parotid and Submandibular Regions

Swellings in the parotid region: skin and subcutaneous lesions, preauricular lymph nodes, parotid salivary gland, masseter, mandible, artery, and nerve.
Swellings in the submandibular region: skin and subcutaneous lesions, submandibular lymph nodes, submandibular salivary gland, masseter, mandible, artery, and nerve.

Important Notes

Operative treatment of facial nerve injuries: nerve suture, nerve graft, hypoglossal anastmosis, and plastic operation.
Frey's syndrome: may follow surgery in the region of the parotid gland.

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Description

This quiz covers the functions of the salivary gland, including starch digestion and taste sensation, as well as various non-neoplastic diseases affecting the gland, such as congenital diseases, infections, and degenerative diseases.