Salivary glands

Question 1

What are the 3 major pairs of salivary glands?

Answer 1

Parotid
Submandibular
Sublingual

Question 2

What usually causes inflammation of salivary glands?

Answer 2

Infection

obstructing calculus

Question 3

what usually causes acute bilateral enlargement?

Answer 3

Mumps

Question 4

what usually causes acute unilateral enlargement?

Answer 4

Mumps

Acute parotitis - ascending oral inf

Question 5

where do most tumours occur?
what is the most common histological type of these?
who do they commonly affect and do how they present? what is rx?

Answer 5

i. parotid
ii. pleomorphic adenoma
iii. middle age
iv. slow growing painless lump
v. superficial parotidectomy

Question 6

what is the most common cause of recurrent unilateral sx?

Answer 6

Stones

Question 7

How do stones usually present? what gland do they usually occur in? what is rx?

Answer 7

red
unilateral pain and swelling on eating
submandibular
rx: remove distal stones via mouth, excise gland if contained w/in it

Question 8

What investigations can be used to evaluate lumps?

Answer 8

sialography

plain XR

Question 9

How do malignancies usually present?

Answer 9

rapid growth
fixed mass
CN VII involvement - palsy
pain

Question 10

What is the rx of malignancies?

Answer 10

Surgery + radiotherapy

Question 11

What are Warthins tumours?

Answer 11

benign bilateral parotid tumours

Question 12

What benign tumours occur most commonly in children <1yr

Answer 12

haemangiomas

Question 13

what is the rx of most benign tumours ?

Answer 13

superficial parotidectomy

Question 14

What is the rx of most malignant disease?

Answer 14

radical parotidectomy (may require resection of the facial nerve)

Question 15

How does HIV infection present in terms of parotid disease?

Answer 15

Lymphoepithelial cysts

bilateral, multi cystic symmetrical swelling

Question 16

How does Sjogrens syndrome usually present in terms of salivary glands?

Answer 16

Parotid enlargement
Xerostomia (dry mouth)
dry eyes
bilateral non tender enlargement of parotids

Question 17

how can sarcoid present in the salivary glands? which gland is affected?

Answer 17

parotid, bilateral swelling, non tender

+/- xerostomia

Question 18

What is xerostomia?

Answer 18

dry mouth

Question 19

What are complications of xerostomia?

Answer 19

dental caries

candida infection

Question 20

What are causes of xerostomia?

Answer 20

hypnotics + tricyclics
antipsychotics 
beta-blockers, diuretics
dehydration 
ENT radiotherapy
Sjogrens 
SLE + scleroderma
HIV/AIDs
sialolith (stones)

Question 21

What is management of xerostomia ?

Answer 21

• increase oral fluids
• good dental hygiene
• saliva substitute
• chewing gum/sweets

Question 22

where do most salivary gland stones occur?

Answer 22

submandibular gland

Question 23

What are stones usually composed of?

Answer 23

calcium phosphate or calcium carbonaet

Question 24

how do stones tend to present?

Answer 24

colicky pain

post prandial swelling

Question 25

what causes sialadenitis ?how does it present?

Answer 25

usually staph aureus infection

pus leaking from the duct +/- erythema

Question 26

What is a complication of sialadenitis

Answer 26

abscess - can spread and occlude airway