Salivary Gland Enlargement Flashcards
What are the 3 reasons for change in gland size?
- Viral inflammation
- Secretion retention
- Gland hyperplasia
What can cause viral inflammation in glands?
- Mumps
- HIV
What can cause secretion retention in glands?
- Mucocele
- Duct obstuction
What can cause gland hyperplasis?
- Sialosis (unknown cause)
- Sjogrens syndrome
What are the symptoms of mumps?
- Headache
- Joint pain
- Nausea
- Dry mouth
- Mild abdominal pain
- feeling tired
- Loss of appetite
- Pyrexia of 38C or above
What type of virus is mumps and how is it spread?
- Paramyxovirus
- Droplet spread
- Incubation 2-3weeks
- Symptomatic txt only
What is the type of enlargement seen in salivary glands due to HIV?
- Lympho-proliferative enlargement
When you have unexplained salivary swelling what disease can this be associated with?
- HIV
- Pt may present with no HIV symptoms but also can present with HIV diagnosis
What is a Mucocele?
- Swelling in the mucosa filled with saliva
Where can you find a mucocele?
- In the duct
- Extravasated in to the tissues (mucous extravasation system)
- Common to find in lower lip and soft palate (areas of trauma)
What will a pt complain of for a mucocele?
- Recurrent swelling which may burst in mater of days
- Salty taste when bursts
When should a mucocele be removed by oral surgeon?
- If mucocele becomes hard but will not cause damage if left alon until child becomes of age to get LA instead of GA to remove
What is a Subacute obstruction?
- Swelling associated with the major glands (usually submandibular as duct is longer than parotid)
- Usually associated with duct blockages either by stones or mucous plugging
With a subacute obstruction what will the pt complain of in regard to the swelling?
- Swelling associated with meals
- Swelling increases when ot eating as salivary flow starts
- Swelling decreases when salivary flow stops after meal finished
What is the progression rate of subacute obstruction?
- Slowly progressive over weeks
-Eventually becomes fixed and painful as gland is blocked and saliva cant escape
In a subacute obstruction what is the difference in outcome between submandibular and parotid?
Usually duct blockage in submandibular
- Usually duct structure in parotid
What are some causes of subacute obstruction?
- Sialolith (stones)
- Mucous plugging
- Ductal damage from chronic infection
What does this image show?
- Lower true occlusal radiograph
- Acceptable
- Sialoltih (stones)
What investigations can be done for subacute obstruction?
- Low does plain radiography
- Lower true occlusal
- Sialography (only when infection free as can further push mucous plug into gland and cause worse blocakge)
- isotope scan if gland function uncertain
- Ultrasound assessment of duct system
What does this image show?
- OPT
- Shows right side submandibular
What does this image show?
- Duct stricture using sialogram
- Stone in the parotid duct causing a stricture
- Infection most likely to have cause stone and stricture
What does this image show? How does this occur? What childhood disease may cause this?
- Duct dilatation
- Defects prevent normal emptying
- Micro0orgs grow and lead to persisting and recurrent sialadenitis
- Gland function gradually lost and persisting infections lead to gland removal
- Recurrent Parotitis of childhood
What is the management of Subacute obstruction?
- Surgical sialolith removal
- If no stone present then use Sialograpahy (washing effect)
- Consider gland removak if fixed swelling
what is the outcome of subacute obstruction if not managed?
- Reformation of stone/obstruction
- Deformity of duct - can lead to stasis and infection
- Gland damage with low salivary flow, ascending infection
What is Sialosis?
- Major salivary gland enlargement with no obvious glandular cause
- Shows bilateral enlargement with no focal enlargement and generalised diffuse change
Perhaps
- Alcohol abuse
- Cirrhosis
- Diabetes Mellitus
- Drugs
