Mouth 3 Flashcards
Salivary gland disorder without inflammation (just a stone)
Sialolithiasis
Salivary gland disorder w/ inflammation or infection
Sialadenitis
Etiology of Sialolithiasis / Sialadenitis
Uncertain, but is related to:
- reduced salivary flow
- inflammation
- localized injury
Most stones of sialolithiasis / sialadenitis occur where?
Wharton duct
Pain, swelling caused by eating or anticipation of eating
Sialolithiasis / Sialadenitis
Conservative tx for Sialolithiasis / Sialadenitis
- Hydrate
- Heat
- Massage
- “milk” by massaging duct
Sialagogues
Have pt suck on something to tx sialolithiasis / sialadenitis
Which type of infection would you monitor for in patients w/ Sialolithiasis / Sialadenitis?
S. aureus
What would you give a pt w/ either Sialolithiasis or Sialadenitis?
What tests would you order?
- IV or Oral abx
- US or CT to look at duct
Acute infection of parotid gland
Suppurative (pus) Parotitis
Is Suppurative Parotitis viral or bacterial?
Either
Salivary stasis allows retrograde flow w/ the oral flora
Suppurative Parotitis
Sudden onset of firm, erythematous swelling of pre/post auricular areas extending to angle of mandible
Suppurative Parotitis
- Severe pain/tenderness
- Trismus (diff opening mouth)
- Dysphagia
- Fever/chills
Suppurative Parotitis
- Associated w/ elevated amylase
- US, CT, MRI
- Surgical I&D if no improvement in 48 hrs
Suppurative Parotitis
Complications:
- Massive neck swelling
- septicemia (sepsis)
- osteomyelitis (bone infection)
Suppurative Parotitis
Most common “neck space” infection
Ludwig’s Angina
Cellulitis of sublingual and submaxillary spaces
Ludwig’s Angina
Arises from infection of tooth roots of mandible
Ludwig’s Angina
- Edema, erythema, induration of upper neck & floor of mouth
- Fever, fatigue, neck pain, elevated tongue
- Airway compromise
Ludwig’s Angina
- Get a CT
- Secure/Monitor airway
- Tracheostomy may be needed
- Hospitalize
- IV abx
Tx for Ludwig’s Angina
Lateral soft tissue neck constriction of upper airway
Ludwig’s Angina
> 90% of oral cancer is which type?
Squamous Cell Carcinoma (SCC)
Cancer of oral cavity associated w/ ulcers or masses which do not heal.
Squamous Cell Carcinoma
(NEED biopsy)
What causes up to 80% of all SCC of head/neck?
Tobacco and Alcohol
Papules, plaques, erosions, ulcers which do not resolve
Clinical presentation of SCC
How is SCC diagnosed?
Biopsy by ENT
Male or female?
- Oral cavity/pharynx cancers
- Thyroid cancers
- Males
- Females
What is associated w/ SCC of tongue, tonsils, and pharynx in 46% of post mortem specimens?
HPV (16, 18, 31)
Most common genetic abnormality in head/neck cancers. (smoking/alcohol cause mututation in the gene)
P53 Tumor Suppressor Gene
- Mass in neck
- Hoarse for over 2 weeks
- Lump below/in front of ear
- Persistent oral ulcer/lesions
Refer to specialist
