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Oral Disease > Salivary Disease - Non-Neoplastic Lesions > Flashcards

Salivary Disease - Non-Neoplastic Lesions Flashcards

1
Q

List the major salivary glands

A

Parotid
Submandibular
Sublingual

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2
Q

Submandibular gland features?

A

Mixed (serous and mucus secretion)

60-70% of saliva

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3
Q

Sublingual gland features?

A

Located in floor of mouth (under tongue)
Mucus secretion
10% of saliva

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4
Q

Parotid gland features?

A

Preauricular region
Serous secretion
20-40% of saliva

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5
Q

Minor salivary gland features?

A 
Found throughout mouth:
- Lips
- Palate
- Cheeks
- Tongue
Approx 800 in total
Mucus secretion
5-10% of saliva
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6
Q

Examples of non-neoplastic lesions of salivary glands?

A

Developmental anomalies
Inflammatory: Sialoadenitis
Obstruction and trauma

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7
Q

Developmental anomalies of salivary glands?

A

Very rare
May see aplasia
Heterotopic salivary tissue: Safne’s bone cavity

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8
Q

Types of sialoadenitis?

A

Acute - bac or viral

Chronic - bac, post-irradiation, sjogren’s syndrome

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9
Q

Acute parotitis features?

A

Ascending infection
Linked to oral bac including staph. aureus
Acute swelling and pain
Pus exudes ducts

Usually secondary to dry mouth:

  • Drug induced
  • Sjogren’s syndrome
  • Radiotherapy
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10
Q

Recurrent parotitis in adults?

A 
Recurrent infection secondary to dry mouth 
40-60 years old
F>M
Often unilateral 
Secondary to xerostomia 
Due to recurrent ascending infections
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11
Q

Recurrent parotitis in children?

A 
4 months - 15 years old
M = F
May resolve at puberty 
Bilateral parotid swelling
No obvious cause or predisposing factors 
Days - weeks duration
Sudden onset
May be evidence of infection:
- Pain, redness, fever 
Sialography shows punctate sialectasis 
Reduced salivary flow
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12
Q

Viral sialoadenitis - features of mumps?

A 
Epidemic parotitis 
Mumps virus - paramyxovirus 
Incubation period 2-3 weeks 
Direct or droplet spread 
Acute bilateral parotid swelling 
Usually in children
Very painful, fever, malaise
Self limiting 10-14 days 
May spread to other glands/organs
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13
Q

Complications of mumps?

A 
Orchitis (30%)
Meningitis (10%)
Oophoritis (5%)
Pancreatitis (5%)
Cranial nerve palsies
VIII nerve deafness
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14
Q

What is chronic sialoadenitis secondary to?

A

Chronic sialoadenitis is usually secondary to duct obstruction due to calculi

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15
Q

What is a salivary calculi?

A

An accumulation of calcium and phosphate salts which deposit in the salivary ducts or gland

  • Usually unilateral
  • M:F
  • Submandibular gland approx 80%: 35% in FoM, 35% in posterior duct, 30% in gland
  • Parotid 20%
  • Minor glands 1-15%
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16
Q

What is calculus?

A

Concentric accumulation of calcium salts around cellular debris and mucous

17
Q

What can salivary duct obstruction by calculus cause?

A

Obstruction by calculus = saliva retention and inflammation = swelling and fibrosis = fibrosis and loss of function

18
Q

Radiation sialoadenitis features?

A

Occurs at doses over 20Gy
High risk of permanent damage over 30Gy
Severe damage at doses of over 50Gy

Serous acini most sensitive
Inflammation and fibrosis of glands
Loss of function

19
Q

What result from obstruction and trauma to the salivary glands?

A 
Salivary calculi
Mucous cysts (mucoceles) 
Necrotising sialometaplasia
20
Q

Types of mucoceles?

A

Mucous extravasation cyst

Mucous retention cyst

21
Q

Mucocele features?

A 
Usually extravasation cyst
Lower lip most common site
Painless swelling
Rupture and recur
Most common in children
22
Q

Mucous extravasation cyst features?

A

85% of mucoceles
Younger age groups
Peak 20-30yrs old
Lower lip commonest site (50% plus)
Lined by granulation tissue and fibrous tissue
Due to ruptured duct
Lumen full of mucous and macrophages filled with mucous

23
Q

Mucous retention cyst features?

A 
15% of mucoceles
Older age group 50-60 years old 
FOM, buccal mucosa
Due to blocked duct = dilation and cyst formation 
Lined by duct epithelium 
Lumen filled with mucous
24
Q

Ranula features?

A 
Usually children
Usually extravasation cyst
Arise in FOM in sublingual gland
Painless swelling
2-3cm in size 
Rupture and recur
25
Q

Necrotising sialometaplasia features?

A 
Can be mistaken for malignancy
Presents as indurated, ulcerated swelling
Usually on palate
Heals spontaneously in 4-8 weeks
Benign inflammatory disease
26
Q

Necrotising sialometaplasia histology?

A

Squamous metaplasia of salivary ducts - islands of squamous epithelium deep in CT
Necrosis of acini

Oral Disease (42 decks)

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