Salivary Gland Pathology Flashcards
Most common site for SUPERFICIAL mucoceles
Posterior buccal mucosa
Most common site and age for mucoceles
- lower lip mucosa
- children and young adults (due to trauma)
Histology:
Sub-mucosal spilled mucin surrounded by granulation tissue response. Minor salivary glands often visible adjacent to lesion.
Mucocele
Mucocele that dissects the mylohyoid muscle and causes cervical swelling.
Plunging ranula
How do you treat a ranula?
Remove the feeding sub-lingual gland or marsupialize
What is the difference between a mucocele and a salivary duct cyst?
Mucocele: granulation tissue lining, usually stemming from ruptured duct.
Salivary duct cyst: epithelial lining, developmental origin.
Epithelial lined cavity in oral mucosa.
May be caused by an obstruction in a duct.
Salivary Duct Cyst
Major gland most often obstructed by sialoliths.
Submandibular
Histology:
Intraductal calcified mass with concentric laminations.
Sialolithiasis
Inflammation of the salivary glands.
Sialadenitis
Species most often involved in Acute Bacterial Sialadenitis
Staph. aureus
Non-infectious causes of sialadenitis
- Sjogren syndrome
- sarcoidosis
- radiation therapy
- various allergens
Cheilitis glandularis is most common in whom, and at what location?
- Middle aged and older men
- Minor salivary glands of lower lip mucosa
Treatment for persistent Cheilitis Glandularis with actinic damage
Vermillionectomy
Causes of Sialorrhea
- local irritation (new dentures, aphthous ulcer…)
- Gastroesophageal Reflux Disease
- Heavy Metal and Rabies
- Medications like Lithium and Cholinergic Agonists
sialorrhea may result from poor neuromuscular control, as in patients with:
- Mental retardation
- Cerebral palsy
- surgically resected mandible
Idiopathic Paroxysmal Sialorrhea
- Episodes lasting 2-5 minutes
- associated with prodrome of nausea or epigastric pain
How to treat sialorrhea
- anticholinergics
- transdermal scopalamine (age 10+ yrs)
- surgery (if neuromuscular problem)
- treat GERD (if GERD is the cause)
Causes of Xerostomia
- DRUGS!!!!
- Anxiety/Emotion
- Fluid/Electrolyte issues
- radiation/chemo
- Autoimmune disease
- Advanced age
Implications of Xerostomia
- Thirst
- Cervical caries
- Thick, ropey saliva not protective
- Shift in microflora
- Adverse effects on sleep
What kinds of drugs cause xerostomia?
antidepressants, antihistamines, antihypertensives, antiparkinsonians, antipsychotics, beta blockers, diuretics, GERD
Ways to dampen effects of xerostomia
- let ice melt in mouth
- sip water frequently
- avoid alcohol and caffeine
- humidifier at night
- lubricate lips
- fluoride
Key ingredients in Xerostomia oral hygiene products (biotene, oral balance gel)
- lactoperoxidase
- lysozyme
- lactoferrin
Sialogogues include:
-Pilocarpine
-Cevimeline hydrochloride
(contraindicated in narrow-angle glaucoma)
Chronic, systemic autoimmune disease, principally involves the salivary and lacrimal glands. It produces xerostomia and xerophthalmia, which causes keratoconjunctivitis sicca.
Sjogren Syndrome
Tear secretion diagnostic for Sjogren Syndrome
Schirmer test
-<5mm/5min suggests keratoconjunctivitis sicca
