Salivary Glands Flashcards
What is sialadenitis?
Inflammation of salivary gland
Which salivary gland is most commonly affected by sialadenitis?
Parotid gland –> parotitis
What are the infective causes of sialadenitis?
Viral (most common):
- mumps
- coxsackie
- parainfluenza
- HIV parotitis (non-painful swelling)
Bacterial:
- S. aureus
- S. viridans
- S. pyogenes
What are the other causes of sialadenitis (apart from infective)?
Stones
Malignancy
Autoimmune (sarcoidosis, Sjogren’s, GPA)
Idiopathic
What are the clinical features of sialadenitis?
Painful swelling + tenderness of gland
Pyrexia, lymphadenopathy, erythema of gland
Infectious cause –> purulent discharge from duct +/- abscess formation
How is sialadenitis managed?
Usually conservatively with fluid + analgesia
Artificial saliva in production impaired
Antibiotics if bacterial causes suspected
Sialologues e.g. lemon juice to promote saliva production
Incision + drainage of abscesses
What can be done for recurrent sialadenitis?
Surgical removal of the gland
What is sialolithiasis?
Calculi (stones) in salivary gland or duct
Why does sialolithiasis occur?
Stones form following stagnation of saliva
Typically made of calcium phosphate + hydroxyapatite
In which gland does sialolithiasis most commonly occur and why?
Submandibular
- duct is long
- flow of saliva against gravity
- secretions are more mucoid (parotid more serous)
What are the risk factors for sialolithiasis?
Medication: diuretics, anticholinergics Dehydration Gout Smoking Chronic periodontal disease Hyperparathyroidism
What are the symptoms of sialolithiasis?
Usually asymptomatic
Some get intermittent facial swelling associated with eating - may or may not be painful
What are the signs of sialolithiasis?
When gland palpated –> saliva seen at duct orifice + presence of small stones
A stone may be palpable in the duct
Gland may be tender if infection
How is sialolithiasis investigated?
USS –> good for analysing whole gland + periglandular structures
or plain X-ray –> stones are radio-opaque
How is sialolithiasis managed?
Oral hydration, analgesia + sialologues e.g. lemon juice
Antibiotics if concurrent infection
