Kelainan Kelenjar Saliva.pdf

SALIVARY GLAND DISEASE Anggun Mauliana Putri Department of Oral Medicine Faculty of Dentistry Hasanuddin University FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  LEARNING OBJECTIVE Students are expected to be able to explain the...

SALIVARY GLAND DISEASE Anggun Mauliana Putri Department of Oral Medicine Faculty of Dentistry Hasanuddin University FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  LEARNING OBJECTIVE Students are expected to be able to explain the etiology, mechanism, diagnose, determine prognosis, and treatment plan of Sialolithiasis, Sialadenitis, Mucocele, and Ranula. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Saliva Saliva is a product of the major and minor salivary glands. Consists of a complex mixture of water, organic and non-organic components. Most saliva is produced by the major salivary glands (Parotid, Submandibular and Sublingual). FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialolithiasis Sialolithiasis is a condition characterized by blockage of the salivary glands or their excretory ducts due to the formation of concrete or calcareous sialoliths. Approximately 30% of all salivary disorders are sialolithiasis. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialolithiasis Clinical Features: Acute, painful, and intermittent swelling. 97.98 % Salivary glands with obstructive sialoliths are often enlarged and tender 🡪 infection, fibrosis, and gland atrophy. Fistula, sinus tract, or ulceration may occur over the stone in chronic cases. Examination of the soft tissues around the ducts may reveal edema and inflammation. Bidigital palpation along the ductal pathway can confirm the presence of stones. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialolithiasis Diagnosis ❑Radiographs 🡪 Occlusal radiographs are recommended for the submandibular gland. ❑CT (Computed Tomography) ❑Sialoendoscopy ❑DD/ benign or malignant cyst or tumor. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialolithiasis Management Acute phase: supportive therapy and symptomatic. Exacerbating conditions: surgical intervention for drainage or removal of the blockage in the duct may be required. After the acute phase: surgery can be planned FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialadenitis Recurrent infection in the submandibular gland that can be accompanied by sialolith stones or blockages. Usually occurs after obstruction but can develop for no apparent reason. Chronic inflammation can occur in the parenchyma glands or ducts caused by infection (sialodochitis) from Staphylococcus aureus, Streptococcus viridians or Pneumococcus. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialadenitis Clinical Features: ❑Usually unilateral ❑Swelling and pain, and mild trismus. ❑Swelling lasts 2-10 days, recur after a few weeks or months. ❑Fever occurs when infection develops ❑Firm and diffusely tender, with erythema and edema of the overlying skin. ❑ Enlargement 🡪 abscess FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialadenitis Diagnosis Diagnosis requires adequate biopsy specimens A complete clinical history should be provided to the pathologist Use of sonography Check the amount of saliva FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  Sialadenitis Management The duct obstruction is removed. The acute period: antibiotics. Parotidectomy Avoid the etiology Monitoring the condition of secondary infection FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  MUCOCELE & RANULA FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/ FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/ FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  MUCOCELE Clinical Features Typically appear as dome-shaped mucosal swelling. Size : can range from 1 or 2 mm to several centimeters. Often imparts a bluish translucent (deeper mucocele may be normal in color). Relatively painless mass of smooth surface Characteristically it is fluctuant. Location : the lower lip is by far the most common site. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  MUCOCELE Differential Diagnosis Salivary gland neoplasm (especially mucoepidermoid carcinoma) Vascular malformation Venous varix Soft tissue neoplasm such as neurofibroma or lipoma. Management Surgical excision. Removal of associated minor salivary glands along with the pooled mucus 🡪 prevent recurrence. No treatment is required for superficial mucoceles 🡪 rupture spontaneously and are short-lived. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  RANULA Clinical Features ❑Ranula = swollen belly of a frog ❑Usually, the lesion forms on one side of the lingual frenum. ❑Bluish ❑The size of the lesions may vary and may cause deviation of the tongue. ❑Deep lesions that extend along the fascial plane are referred to as Pluging Ranulas and can be large, extending to the neck. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  RANULA Management ❑Surgical intervention is the treatment of choice for ranulas. ❑A marsupialization procedure as the initial treatment. ❑The frequency of recurrence is related to the surgical technique chosen (marsupialization, 67%; ranula excision, 58%; sublingual gland excision, 1%) 🡪 excision of the lesion and gland should be considered. ❑Intralesional corticosteroid injections. FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  QUIZ RANULA VS MUCOCELE FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/  REFERENCES FACULTY OF DENTISTRY, HASANUDDIN UNIVERSITY https://dent.unhas.ac.id/ Thank You [email protected] FACULTY OF DENTISTRY HASANUDDIN UNIVERSITY