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Oral Surgery > Salivary gland disorder > Flashcards

Salivary gland disorder Flashcards

1
Q

size of parotid gland - general

A

up to TMJ

to mandible and behind

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2
Q

von frey syndrome

A

gustatory sweating

  • Result after trauma occured to the parotid region of the face

instead of going to parotid gland – goes to sweat gland

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3
Q

three major etiology of infections

A

viral - like mumps

from stones - like mucus plug (like secondary)

retrorade infection

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4
Q

high temp dysphagia trismus swelling and malaise - may be from?

A

pus draining from wharton’s duct - submandibular gland infection

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5
Q

features of chronic infection / blockage

A

diminshed salivary flow

turbind, viscous discharge

pain and swelling seen at meal time

moderate enlargment of the affected gland

scarring pattern seen on sialolith

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6
Q

typically swells at meal time

A

chronic paraotid infection

with turbid viscous discharge milked from duct

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7
Q

tx for glandular

A

hydration – water
plus acidic like lemons and pickles

stimulation

ductile dilation – probing - only chronic though - not acute infections

antibiotics

sialolothectomy

sialolithectomy

sialogram

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8
Q

‘easy’ sialothith to remove

A

can almost see it

  1. traction suture – suture ligation of duct

2.

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9
Q

clinically important parotid gland anantomy

A
  1. superficial / deep lobe
  2. facial nerve courses through
  3. retromandibualr relationship
  4. course of stenson’s duct
    - over masseteric muscle
  5. accessory gland

its large!
- also because wraps around behind - trismus could be associated

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10
Q

clinically important submandibular gland anatomy

A
  1. muscualr triangle
    - allow these muscsles to swallow
    - symptoms = difficulty swallowing
  2. facial nerve, artery and vein
  3. hypoglossal nerve
  4. whartons duct
  5. lingual nerve
    - crossing UNDER WHARTON’S DUCT
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11
Q

whartons duct?

A

from submandibular gland to oral cavity

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12
Q

stensons duct

A

from parotid gland

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13
Q

clinically important sublingual gland anatomy

A
  1. deceptively large size
  2. directly drains by 8-20 ductiles
    - can be injured
    - like mucocele formed
  3. bartholin’s duct into whartons
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14
Q

trauma examples

A
  1. mucocele
  2. ranula
  3. laceration of salivary duct
  4. salivary fistula
  5. von frey syndrome
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15
Q

ranula is

A

when the sublingual gland has been injured

mucous pulling underneath

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16
Q

typical mucocele

A

dome shaped

fluid filled

non ulcerated

moveable

can occur wherever minor salivary glands are

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17
Q

very large fluctuant swelling in the area of the sublingual gland

A

ranula

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18
Q

chance of reoccurence when marsupilization ? next what?

A

yes can happen – try again

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19
Q

ranula can be cause by - example he gave

A

trauma from sunction tip / high speed suction in dental procedure

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20
Q

pt. with x-ray of face with discontinuity defect

A

possible FRACTURE

STENSONS duct is injured – from parotid

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21
Q

typical acute submandibular gland infection

A

discrete swelling

som hurt to swallow

PUS milked from wharton’s duct

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22
Q

acute parotiditis presentation

A

sudden onset

mild trismus

fever

pre and infra auricular swelling

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23
Q

tx for the acute

A

antibiotics – not going to go into an acutely infected duct area

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24
Q

pt says has acute parotid glan infection but presents with multiple swellings

A

infection may be secondary to CANCER

  • had lymphoma
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25
Q

not tender swollen parotid gland

A

lymphoma

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26
Q

pain that is suggestive of chronic infectin / blockade

A

pain and swelling at MEAL time

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27
Q

turbid viscous discharge milked from out of duct more likely to be

A

CHRONIC

  • typically swelling at meal times
28
Q

treatment of infections

A
  1. HYDRATION
  2. stimulation
    - acidic / lemon/ pickles
    - right behind incisors – get them to salivate
  3. ductile dilation
  4. antibiotics
  5. sialolithectomy
  6. sialogram - inject die into it
  7. sialoendoscopy
29
Q

when can yuo put something INTO the duct

A

during CHRONIC LOW GRADE infection

NOT acute

30
Q

dilate the duct

A

important in treatment in chronic low grade infection

31
Q

what should see from sialogram

A

continual taper of the duct but with the die we can see the obstruction

dialates BEHIND OBTRUCTION

32
Q

main locations we see salivary stones in the mandible

A
  1. orifice of duct
  2. middle of it
  3. point of exit -
33
Q

always put what behind the gland when retrieving stone

A

TRACTION SUTURE

- if dont stone will be pushed back further

34
Q

incision made where on lower?

making sure to keep away from?

A

in anterior portion of the mouth make incision TO THE MEDIAL ASPECT OF THE DUCT

if cut into where sublingual will be – too lateral can get ranula

35
Q

ake incision too lateral?

A

can get secondary ranula

36
Q

traction suture so

AKA

A

stone cannot go further back

made BEFORE making any incision

AKA LIGATION suture

37
Q

indication to remove an acute salivary stone

A

based upon LOCATION – lie if you can get it - get it

38
Q

example with a long history of episodic pain and submandibular swelling which is getting worse

dx by?

A

small round radio-opaque somewher ein the subMANDIBULAR area

inject the DIE@@
- trying to push it in - and it is not working past the stone

  • so identitifed that the stone is in the duct
39
Q

neoplasia aka

A

benign tumors

40
Q

occurence of benign tumors from most to least

A
  1. parotid (90% will be benign)
  2. minor salivary glands ( 40- 60 % will be malignant)
  3. submandibular
  4. sublingual
    - has the most occurence of a MALIGNANT one
41
Q

90% of the benign tumors are ___

A

pleomorphic adenomas

42
Q

wharton’s tumor?

A

8% of the parotid tumors

commonly a BILATERAL tumor

ELDERLY MEN

43
Q

bilateral tumor in elderly men close to tail of parotid

A

WHARTON’S TUMOR

44
Q

TUMORS CAN BECOME MALIGNANT

A

YES- TRUE

45
Q

malignant salivary tumors

A

mucoepidermoid carcinoma

adenoid cystic carcinoma

adenocarcinoma

malignant pleomorphic adenoma

lymphoma

squamous cell carcinoma

acinic cell carcinoma

46
Q

highlighted malignant

A

lymphoma (second most malignant in head and neck region and squamouos cell carcinoma

47
Q

pleomorphic adenoma

A

can become malignant in a long standing

48
Q

firm mass - cannot rule out

A

tumor -malignancy

like a lymphoma

49
Q

facial paralyiss can be a presentation associated with

A

cancer

loss of lines in forehead

close not closing

50
Q

pt presented with TMJ pain and swelling in the pre-auricular area

A

metastic colon cancer to the parotid gland

51
Q

statistically sublingual gland tumors should be

A

malignant

- but still can present as a pleomorphic adenoma

52
Q

chance of malignacy from most to least

A
  1. sublingual
  2. submandibular
  3. parotid
53
Q

90% of the benign tumors are

A

pleomorphic adenomas

54
Q

nicotinic stomatitis

A

inflammation of the minor salivary glands

each one of them can become a tumor of one

55
Q

6 months draining a lesion?

A

most likely not an infection

tumor of salivary gland on the palate

if locate NO SOURCE OF INFECTION – doing a biopsy

56
Q

doing incision and drainage on non odontogenic?

A

NO

57
Q

mucocele should NOT present where

A

in the posterior retromolar pad area

muco-epidermoid carcinoma or salivary gland tumor until we prove otherwise

front or floor of mouth probably a mucocele

58
Q

upper lip mass vs lower lip mass

A

lower - mucocele

upper - tumor

59
Q

indurated / hard mass on buccal mucosa associated with V2 parasthesia

A

think TUMOR

adenomatoid cystic carcinoma

60
Q

NON inflammatory enlargment of parotid glands

A

sialosis

benign salivary hypertrophy

61
Q

causes of sialosis

A
  1. malnutrition
  2. chronic alcoholism
  3. diabetes
  4. HIV disease
62
Q

necrotizing sialometaplasia

hallmark sign?

A

INTENE ACUTE PAIN

necrotic slough of tissue frequently seen

Patient will say something dropping / coming out of the roof of my mouth

THIS WILL HEAL

63
Q

___ puts at risk for developing lymphoma

A

sjorgen’s syndrome – 40% increased risk to develop lymphoma

64
Q

presenting chatacteristics of sjorgen’s syndrom

A

xerophthalmia - dryness in eye

xerostomia

rheumaotid arthritis

40X more likely to develop lymphomas

65
Q

common presentation of sialosis

A

NON INFLAMMATORY ENLARGMENT

-BILATERAL
PAROTID ENLARGEMENT

SEEN IN 
- DIABETICS
- ALCOHOLIC 
- MANLUTRITION
HIV DISEASE

Oral Surgery (26 decks)

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