L9: Salivary Gland Benign Diseases Flashcards
Def of Sialadenitis
Inflammation of salivary glands
Types of Sialadenitis
- A disease that is Endemic is found in a certain geographic region or in a specific race of people. Malaria is endemic to parts of Africa.
- Epidemic describes a disease that is widespread, affecting a large number of individuals within a population, community, or region at the same time.
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Predisposing factors of Acute Suppurative Sialadenitis
- Bad oral hygiene.
- Salivary duct obstruction by food particles, F.B. or stone.
- Dehydration (postoperatively).
- Debility.
Organism Causing Acute Suppurative Sialadenitis
- Staph. aureus (commonest),
- Streptococci and Pneumococci.
Roue of entry of Acute Suppurative Sialadenitis
- Direct → along duct from mouth (commonest), or from a nearby focus.
- Blood borne.
what is the most commonly affected gland by Acute Suppurative Sialadenitis?
Parotid Gland
Pathology of Acute Suppurative Sialadenitis
- The parotid is the commonest gland involved.
- The gland and duct are congested edematous and may suppurate.
CP of Acute Suppurative Sialadenitis
Investigations for Acute Suppurative Sialadenitis
Complications of Acute Suppurative Sialadenitis
TTT of Acute Suppurative Sialadenitis
- Conservative
- Surgical
Conservative TTT of Acute Suppurative Sialadenitis
After 3 days of conservative treatment, patient either:
Indications of Surgical TTT of Acute Suppurative Sialadenitis
1) Failure of conservative treatment.
2) If there are signs of suppuration (abscess formation).
Procedure for Removal of Parotid abcess
Procedure for Removal of Submandibular abcess
Etiology of Chronic Sialadenitis
Pathology of Chronic non-Calcular Sialadenitis
what is the most commonly affected gland by Chronic Sialadenitis?
Submandibular
Pathology of Chronic calcular Sialadenitis
why is Chronic Sialadenitis more common in submandibular Gland?
- Secretions of submandibular are more viscid.
- Its duct opens in floor of mouth → obstruction by food.
- Drainage of submandibular gland is independent.
Composition of salivary stones
Ca, Mg phosphate & carbonate.
CP of Chronic Sialadenitis
Chracters of Pain in Chronic Sialadenitis
- Dull aching pain if the stone is in the gland.
- Colicky pain if it is in duct.
Where does Chronic Sialadenitis pain refer to?
- May refer to tip of the tongue or teeth due to irritation of lingual nerve as it hooks around submandibular duct.
What Increases Chronic Sialadenitis pain?
Increases with meal & mastication.
Characters of swelling in Chronic Sialadenitis
- The gland is enlarged & its size is increased after meal.
- Stone in submandibular duct may be felt in the mouth floor.
Signs of Chronic Sialadenitis
Investigations for Chronic Sialadenitis
DDx of Sialadenitis
Compare between Enlarged submandibular salivary gland & Enlarged Submandibular lymph node in terms of:
- Number
- Lemon Test
- Rolling
- Bidigital Examination
- CP
Complications of Chronic Calicular sialadenitis
Complications of Chronic non-Calicular sialadenitis
TTT of Parotid Gland Calcular Sialadenitis
- When the stone is in the duct
Can be removed intraorally.
TTT of Parotid Gland Calcular Sialadenitis
- When the stone is in the gland
- Total conservative parotidectomy, because superficial parotidectomy leads to postoperative salivary fistula due to diseased cystic deep lobe.
TTT of Submandibular Gland Calcular Sialadenitis
- When the stone is Peeping from the orifice
meatotomy
TTT of Submandibular Gland Calcular Sialadenitis
- When the stone is in the duct
TTT of Submandibular Gland Calcular Sialadenitis
- When the stone is recurrent or found in the gland
- Submandibular sialoadenectomy
TTT of Submandibular Gland Calcular Sialadenitis
- When the stone is in the gland
Complications of Submandibular sialoadenectomy
Def of Von Mikulicz Disease
Payhology of Von Mikulicz Disease
The salivary glands are the seat of heavy lymphocytic infiltration
Comlications of Von Mikulicz Disease
It is precursor of lymphoma of salivary gland
TTT of Von Mikulicz Disease
The disease responds to prednisolone
What is Von Mikulicz Disease associated with?
The syndrome includes also:
- Narrowing of the palpebral fissure due to enlargement of lacrimal gland
- Dry mouth
Sjogren syndrome
Dry mouth
Dry eyes
Generalized arthritis
Sicca syndrome
Dry mouth
Dry eyes.
Def of Mucocele
- It is a retention cyst which affects either minor salivary glands (in oral cavity especially in the buccal mucosa) or in the major salivary glands.
What is a complication of Mucocele?
Sialocele due to trauma to the salivary ducts leading to extravasation of the secretion
TTT of Mucocele
Excision of the cyst (and the minor salivary gland if it is arising from it)
Def of Ranula
- A mucocele of the sublingual salivary gland, it presents as large tense bluish swelling in the floor of the mouth which displaces the tongue.
Complications of Ranula
Ranula may push its way through the mylohyoid raphe & protrude to the neck: plunging ranula.
TTT of Ranula
Deroofing & excision of the sublingual salivary gland
Done
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