1 - ENT - Head and neck - Salivary gland disease - Non-neoplastic salivary gland swelling Flashcards
FIRST - common Sx in salivary gland disease
lumps/swelling swelling/pain realted to eating foul taste in mouth dry mouth or eyes speed of onset facial weakness
Non-glandular causes of parotid area swelling
masseter hypertophy adipose loss leaving glands more apparent skin lesions aneurysms and cysts within gland lymphadenopathy 2ndary to infection mastoiditis > abscess
3 conditions giving some sort of salivary gland swelling
parotitis
sialolithiasis
Sjogrens syndrome
4 causes of parotitis
viral (usually) - mumps - possibly also parainfluenza, coxsackie, HIV
bact - staphylococcal
fungal - rare - candidiasis in immsuppressed
others - sarcoid
Presenting complaint in parotitis
foul tasting discharge in mouth
How to treat the different types of parotitis
viral - analgesia and hydration
bact - AB’s sialogoges, massage, possible drainage
fungal - antifungal
Sialolithiasis - what happens to cause which Sx? normally where? can lead to?
stone formation in duct - 80% submandibular
gland swelling and pain, worse when eating , recurrent unilateral Sx
may lead to sialectasis - dilatation of duct
sialolithiasis - Ix and mgmt
plain XR, sialogram, USS
mgmt - remove calculus (via mouth / remove gland)
Sjogrens syndrome - what is it? two types?
chronic inflam autoimmune disorder
primary - more common in females middle aged onset
secondary - to connective tissue disease - RA SLE etc
Sjogrens syndrome - features
dry eyes, dry mouth, parotid swelling, associated autoimmune disease, ^risk of recurrent parotitis and of non-hodgkins b-cell lympoma
3 investigations of Sjogrens (there are others as well)
schirmers test for lacrimation <5mm in 5 mins
carlsson-crittendon for salivary flow
labial biopsy
mgmt of sjogrens
artificial tears/saliva, steroids, parotidectomy
