24 Questions
What percentage of salivary secretion is produced by the parotid gland?
45%
What is the main function of salivary amylase in the oral cavity?
Starch digestion
What is the analogy of sialectasis in the respiratory system?
Bronchiectasis
What is the usual presentation of mumps in a child?
Bilateral painful parotid gland swelling with fever
What is the predisposing factor for acute suppurative sialadenitis?
Poor oral hygiene
What is the typical age range for childhood sialectasis to resolve?
After the age of 15 years
What is the treatment approach for acute attacks of infection in sialectasis?
Antibiotics
What is the self-limiting nature of viral parotitis?
The disease resolves on its own
What percentage of cases of autoimmune salivary diseases develop lymphomas?
20%
What is the purpose of instillation of artificial tears in the treatment of autoimmune salivary diseases?
To combat eye dryness
What is the next step if a patient with autoimmune salivary diseases develops a palpable mass in the parotid?
Needle biopsy
What is the term for enlargement of the salivary gland due to metabolic reasons?
Sialosis
What is the purpose of lip biopsy in the diagnosis of autoimmune salivary diseases?
To examine the minor salivary glands
What is the significance of parotid sialography in the diagnosis of autoimmune salivary diseases?
Shows narrowed ducts and punctate sialectasis
What is the treatment for submandibular salivary fistula?
Submandibular sialadenectomy
What is a common cause of salivary gland enlargement?
Drugs such as sulfisoxazole, phenylbutazone, and iodide containing compounds
What is the method used to visualize the dilated ducts and branches in the diagnosis of sialectasis?
Cannulation of the salivary duct and instillation of contrast material, followed by taking films before and after the patient sucks a lemon for several minutes.
What is the initial treatment approach for sialectasis?
Conservative treatment, including stimulation of salivary flow by citrus drinks and massage of the affected gland to remove epithelial debris.
What is the cause of radiation-induced sialadenitis?
Radiation to the nasopharynx or skull base.
What is the characteristic manifestation of Sjogren's disease?
Dryness of the mouth (xerostomia) and dryness of the eye (xerophthalmia, keratoconjunctivitis sicca).
What is the suspected etiology of Sjogren's disease?
Cytomegalovirus affecting the ducts of the salivary glands, making them antigenic.
What is the increased risk of Sjogren's disease patients compared to the general population?
44 times more prone to the development of lymphoma.
What is the characteristic feature of benign lymphoepithelial lesions?
Progressive lymphocytic infiltration and diffuse enlargement of the salivary glands, particularly the submandibular and parotid.
What is the primary goal of treatment in Sjogren's disease?
Management of symptoms, such as dryness of the mouth and eye, and prevention of complications like lymphoma.
Study Notes
Salivary Gland Disorders
- Sialectasis is a congenital disease characterized by degeneration of the alveolar and duct system, resulting in dilated ducts and alveoli.
- The disease is often unilateral and recurrent, and affected children are initially diagnosed as having mumps.
- Infections, such as viral parotitis and acute bacterial sialadenitis, can cause salivary gland swelling.
- Viral parotitis is a common cause of salivary gland swelling, characterized by bilateral painful parotid gland swelling with fever in children.
Sjogren's Disease
- Sjogren's disease is an autoimmune disease that affects the salivary glands, causing dryness of the mouth (xerostomia) and dryness of the eyes (xerophthalmia, keratoconjunctivitis sicca).
- The disease is more common in women and can also cause rheumatoid arthritis and salivary gland discomfort.
- The aetiology is not exactly known, but it is thought to be caused by a cytomegalovirus that affects the ducts of the salivary glands, making them antigenic.
- Patients with Sjogren's disease are 44 times more prone to developing lymphoma than the general population.
Treatment of Salivary Gland Disorders
- Initial treatment of sialectasis is conservative, involving citrus drinks to stimulate salivary flow and massage to remove epithelial debris.
- Antibiotics are used to treat infections, and surgical excision of the gland is rarely required.
- Sjogren's disease is treated with artificial tears to combat eye dryness, meticulous oral hygiene, and needle biopsy to diagnose lymphoma.
Functions of Saliva
- Food lubrication to allow swallowing
- Cleaning the mouth
- Starch digestion by salivary amylase
- Mediates taste sensation
- Antimicrobial
- Maintenance of tooth integrity
Salivary Gland Anatomy
- The salivary glands produce 1-1.5 L of saliva per day
- 45% of saliva is produced by the parotid gland
- 45% of saliva is produced by the submandibular gland
- 5% of saliva is produced by the sublingual gland
- 5% of saliva is produced by minor salivary glands
Non-Neoplastic Salivary Gland Diseases
- Congenital diseases: aplasia, ectopic parotid tissue, cystic hygroma, and sialectasis
- Infections: viral parotitis, acute bacterial sialadenitis, and recurrent subacute and chronic sialadenitis
- Salivary stones
- Salivary fistula
- Degenerative diseases
- Autoimmune salivary diseases
- Drug-induced, endocrine, and metabolic salivary gland enlargement
This quiz covers the diagnosis and treatment of sialectasis, including the use of contrast material to visualize the ducts and branches, and conservative treatment methods.
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