Textbook recap Flashcards
what is the most common benign salivary gland tumour?
pleomorphic adenoma
how do you differentiate pleomorphic adenoma to warthins tumour?
warthins tumour - bilateral, associated with smoking
what are the key histopathological features of pleomorphic adenoma?
mixed cellular appearance
cells lie within a capsule
satelite cells may lie outside the capsule
what is the chosen treatment for pleomorphic adenoma and why?
parotidectomy or extracapsular dissection, taking a safe margin of normal tissue
the satellite cells may lie outside the capsule
what are the commonest tumours found in salivary glands of children?
lymphagiomas
haemangiomas
neurofibroma
where do you find warthins tumour?
parotid
where do you find adenoid cystic carcinoma?
minor glands
what are signs of a malignant salivary gland tumour?
fixation to surrounding structures
nerve involvement
pain
rapid growth
>4cm size
lymphadenopathy
what is sialadenitis?
inflammation of salivary glands
how does acute bacterial sialadenitis present?
painful swelling
purulent discharge from duct
unilateral
what are the causes of acute bacterial sialadenitis?
it may present as an exacerbation of chronic bacterial sialadenitis which is a complication of duct obstruction
ascending infection of parotids due to dehydrated elderly patients
what is mumps?
viral sialadenitis - an acute, infectious paramyxoviral disease which primarily affects the parotid
symptoms of mumps/ viral sialadenitis?
classically one gland is affected first although bilateral swelling is common.
what is the treatment for sialadenitis?
rehydration
saliva stimulation
recurrent chronic sialadenitis = removal of gland
what is the main histopathological feature of adenoid cystic carcinoma?
‘swiss-cheese’ appearance
spreads locally, particularly along perineural spaces
what are the principles of a parotidectomy?
complete excision of tumour will a margin of healthy tissue and preservation of the facial nerve
what are the rx options for benign tumours of the superficial lobe of the parotid?
extracapsular dissection
segmental superficial parotidectomy
conventional superficial parotidectomy
what are the rx options for malignant tumours of the parotid gland?
radical excision and radiotherapy
symptoms of salivary duct calculi/ obstructive sialadenitis?
history of recurrent pain and swelling in the obstructed gland, before and during meals
where would you most commonly find salivary duct calculi?
submandibular duct
what is the rx for calculi in the submandibular duct?
calculi lying anterior in the duct: pass a suture behind the calculi, dissect the duct intra orally, lift out the stone, marsupialise or reconstruct the duct.
posterior calculi: excise the gland and duct
what is the rx for salivary calculi in the parotid duct?
superficial parotidectomy
