Salivary Gland Swelling

Question 1

25-year old attend w/ lump on lower lip which has been intermittently swelling over last year - give differential

Answer 1

Mucocele - mucous salivary gland cyst
Other: fibroeputhelial polyp/ vascular lesion

Question 2

What qs ask for lip swelling?

Answer 2

Hx - when first noticed, fluctuation size, discharge fluid, bleeding, previous trauma
MH
SH

Question 3

How to explain to pt what muocele is?

Answer 3

Mucous rentention or extravasation cyst called mucocele
Explain 100s of minor salivary gland in lower lip - cyst develops when saliva gland is blocked or leaks saliva which forms cyst

Question 4

What are the two types of mucoceles?

Answer 4

1. Extravasation - damage to saliva gland and duct
2. Retention - decrease or absence of glandular secretion produced by blocked ducts

Question 5

Is there any tx options for pt?

Answer 5

Consider referral for removal under LA

Question 6

Risks of mucocele removed?

Answer 6

Recurrence, nerve damage in lower lip

Question 7

Pt mentions sometimes gets a lump in neck just below jawline that occassionally swells - what could this be?

Answer 7

Swelling of submandibular gland due to stone in duct/ narrowing
Lymph node - viral/ bacterial or malignancy

Question 8

When should neck lump be referred?

Answer 8

Persistently enlarged neck lump of unknown cause

Question 9

What is mealtime syndrome?

Answer 9

Swelling comes on rapidly at thought of food

Question 10

How are salivary stones dx?

Answer 10

Referral secondary care
OPT - only 30% stones are radiopaque
Ultrasound scan - can show stones or constrictions
Sialogram - contrast injected and x-ray taken