Podcast
Questions and Answers
What is the term for the absence of one or more salivary glands?
What is the term for the absence of one or more salivary glands?
What is the most common location of salivary gland stones?
What is the most common location of salivary gland stones?
What is the purpose of lithotripsy in treating salivary gland stones?
What is the purpose of lithotripsy in treating salivary gland stones?
What is the term for the abnormal obstruction or constriction of a salivary gland duct?
What is the term for the abnormal obstruction or constriction of a salivary gland duct?
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What is a possible complication of salivary gland stones?
What is a possible complication of salivary gland stones?
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How often are salivary gland stones visible on x-ray?
How often are salivary gland stones visible on x-ray?
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What is the main cause of mucoceles?
What is the main cause of mucoceles?
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What is the typical size of a mucocele?
What is the typical size of a mucocele?
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What is the lining of a mucocele cyst?
What is the lining of a mucocele cyst?
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What is the common location of mucoceles in adults?
What is the common location of mucoceles in adults?
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What is the typical color of a mucocele swelling?
What is the typical color of a mucocele swelling?
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What is the age group commonly affected by mucoceles?
What is the age group commonly affected by mucoceles?
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What is the typical appearance of a deeper mucous extravasation cyst?
What is the typical appearance of a deeper mucous extravasation cyst?
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What is the primary cause of necrotizing sialometaplasia?
What is the primary cause of necrotizing sialometaplasia?
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What is the typical treatment for a ranula?
What is the typical treatment for a ranula?
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What is the primary complication of radiation-induced salivary gland pathology?
What is the primary complication of radiation-induced salivary gland pathology?
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What is the term for the subjective sensation of oral dryness?
What is the term for the subjective sensation of oral dryness?
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What is the typical microscopic feature of necrotizing sialometaplasia?
What is the typical microscopic feature of necrotizing sialometaplasia?
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Study Notes
Salivary Gland Disorders
- Aplasia: Absence of one or more of the major or minor salivary glands.
Abnormalities of Salivary Glands
- Atresia: Abnormal obstruction or constriction of a salivary gland duct, often due to a stone (Sialolith).
- Aberrancy: Presence of ectopic accessory salivary tissue in an abnormal site.
Sialolithiasis (Salivary Gland Stones)
- Refers to the formation of stones in the salivary glands.
- Most commonly found in the submandibular gland (80%).
- Stones can obstruct Wharton's duct.
- Formed by deposition of calcium salts around an organic nidus.
Diagnosis and Clinical Features of Sialolithiasis
- Usually diagnosed by characteristic history and physical examination.
- Confirmed by x-ray (80% of salivary gland calculi are visible), sialogram, or ultrasound.
- Typically affects adult males.
- Pain originates from the floor of the mouth, worsened by eating.
- May be asymptomatic until palpable in the mouth or seen in a routine radiograph.
Complications and Treatment of Sialolithiasis
- Persistent obstruction of the duct, leading to bacterial invasion, overgrowth, and infection (sialoadenitis).
- Treatment options include: • Stone excision • Lithotripsy (uses shock waves to break up stones) • Interventional sialendoscopy • Simple removal (with 20% recurrence rate)
Mucoceles
- Most common soft tissue lesions
- Typically occur on the lower lip, measuring 3mm to 1 cm
- Caused by damage to the duct and extravasation of saliva
- Lead to mild inflammation and the formation of a cyst with a connective tissue lining
- May be due to duct obstruction and dilation, forming a retention cyst with an epithelial lining
Clinical Features of Mucoceles
- Occur in adults, especially in the minor salivary glands
- Asymptomatic, soft, fluctuant swelling that may appear bluish
- Histological features: cystic cavity contains mucin, lined by compressed ductal epithelium
Mucous Retention cysts
- Site: minor salivary glands of the lower lip, buccal mucosa, ventral surface of the tongue, floor of the mouth, and retromolar area
- Painless, fluctuant, smooth-surface, bluish swelling
- Deeper lesions appear as diffuse swelling with no bluish hue
- Aspiration reveals a viscous material
- Histological features: mucin pool surrounded by compressed granulation tissue infiltrated by chronic inflammatory cells
Extravasation cysts (Ranula)
- Clinical term that includes mucous extravasation and mucous retention cysts
- Occur in the floor of the mouth, appearing as a blue fluctuant swelling
- Etiology: trauma or ductal obstruction by salivary stone
- Age: usually old age
- Size: larger than mucoceles
- Treatment: surgical removal of the lesion with the affected gland
Ranula
- Clinical features: painless soft swelling in the floor of the mouth
- Arises from sublingual and submandibular salivary gland in the floor of the mouth
Necrotizing Sialometaplasia (NS)
- Benign non-infective inflammatory locally destructive lesion of salivary gland
- Resembles malignancy both clinically and histopathologically
- Etiology: ischemia/trauma leading to necrosis of salivary gland tissue
- Site: at the junction between hard and soft palate
- Clinically: begins as tender swelling that ulcerates
- Ulcer is deep, sharply demarcated, with a yellowish-gray base
- Slow healing (6-8 weeks) by secondary intention
- Microscopic features: lobules of salivary gland show necrosis and ductal metaplasia
- Differential diagnosis: squamous cell carcinoma, mucoepidermoid carcinoma, syphilitic chancre, and deep fungal infections
Radiation-induced Salivary Gland Pathology
- Radiotherapy to the head and neck malignancy leads to changes in salivary volume, viscosity, and pH
- Swelling, degeneration, and necrosis of salivary gland tissue, followed by fibrosis
- Complications: caries, oral ulceration, and infections, periodontal diseases, and even osteoradionecrosis
Xerostomia
- Defined as the subjective sensation of oral dryness that may or may not be associated with a reduction in salivary output
- Xerostomia is the term used for the symptom of oral dryness
- Oral dryness is most commonly associated with a reduction in salivary gland output (termed salivary gland hypofunction)
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Description
This quiz covers various disorders related to salivary glands, including aplasia, atresia, aberrancy, and obstructive disorders like sialolithiasis.
