salivary gland Flashcards
causes of salivary gland swelling
Viral causes – Mumps, Coxsackie, Parainfluenza, Influenza A
Bacterial causes – staphylococcus aureus, anaerobic bacteria
Stones/calculis (sialolithiasis) - most common in submandibular glands.
Chronic scarring and strictures (sialectasis)
Benign and malignant tumours
Granulatomous conditions - Sjogren’s syndrome, Sarcoidosis, Wegeners granulomatosis
HIV-related lymphocytic infiltration (usually parotid gland)
Medical causes – chemotherapy agents and radiotherapy (controversial!)
what is parotitis
well-demarcated tender swelling in the preauricular region.
Discoloured saliva may be seen at the parotid duct orifice.
Onset may be insidious and due to ascending infection, viral infection or dehydration and “sludge” in the parotid duct.
what is submandibular sialadenitis
udden-onset swelling and pain in one submandibular gland, usually due to stone impaction. This can occur transiently in patients with stones and strictures, but in established sialadenitis the gland remains swollen and becomes more and more painful. Eating and drinking increase salivation and so make the symptoms worse
causes of chronic sialadenitis
TB
sarcoidosis
HIV
syphillis
what is sialolothiasis
salivary duct obstruction
pain and swelling - worse during meals
episodic facial pain
halitosis
dry mouth
stones are common in which gland
submandibular - wharton duct
stensens duct - parotid gland
Ix for stones
sialography to demonstrate the site of obstruction and associated other stones
US
sialogram
Management for stones
conservative
- analgesia
- hydration
- sialogogues
endoscopy
radiological removal
surgery
- intraoral removal of palpable stones
- removal of salivary gland
sialadenitis
staph aureus infection
Pus may be seen leaking from the duct, erythema may also be noted
Development of a sub mandibular abscess is a serious complication as it may spread through the other deep fascial spaces and occlude the airway
