Textbook recap

Question 1

what is the most common benign salivary gland tumour?

Answer 1

pleomorphic adenoma

Question 2

how do you differentiate pleomorphic adenoma to warthins tumour?

Answer 2

warthins tumour - bilateral, associated with smoking

Question 3

what are the key histopathological features of pleomorphic adenoma?

Answer 3

mixed cellular appearance
cells lie within a capsule
satelite cells may lie outside the capsule

Question 4

what is the chosen treatment for pleomorphic adenoma and why?

Answer 4

parotidectomy or extracapsular dissection, taking a safe margin of normal tissue

the satellite cells may lie outside the capsule

Question 5

what are the commonest tumours found in salivary glands of children?

Answer 5

lymphagiomas
haemangiomas
neurofibroma

Question 6

where do you find warthins tumour?

Answer 6

parotid

Question 7

where do you find adenoid cystic carcinoma?

Answer 7

minor glands

Question 8

what are signs of a malignant salivary gland tumour?

Answer 8

fixation to surrounding structures
nerve involvement
pain
rapid growth
>4cm size
lymphadenopathy

Question 9

what is sialadenitis?

Answer 9

inflammation of salivary glands

Question 10

how does acute bacterial sialadenitis present?

Answer 10

painful swelling
purulent discharge from duct
unilateral

Question 11

what are the causes of acute bacterial sialadenitis?

Answer 11

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

Question 12

what is mumps?

Answer 12

viral sialadenitis - an acute, infectious paramyxoviral disease which primarily affects the parotid

Question 13

symptoms of mumps/ viral sialadenitis?

Answer 13

classically one gland is affected first although bilateral swelling is common.

Question 14

what is the treatment for sialadenitis?

Answer 14

rehydration
saliva stimulation

recurrent chronic sialadenitis = removal of gland

Question 15

what is the main histopathological feature of adenoid cystic carcinoma?

Answer 15

‘swiss-cheese’ appearance
spreads locally, particularly along perineural spaces

Question 16

what are the principles of a parotidectomy?

Answer 16

complete excision of tumour will a margin of healthy tissue and preservation of the facial nerve

Question 17

what are the rx options for benign tumours of the superficial lobe of the parotid?

Answer 17

extracapsular dissection
segmental superficial parotidectomy
conventional superficial parotidectomy

Question 18

what are the rx options for malignant tumours of the parotid gland?

Answer 18

radical excision and radiotherapy

Question 19

symptoms of salivary duct calculi/ obstructive sialadenitis?

Answer 19

history of recurrent pain and swelling in the obstructed gland, before and during meals

Question 20

where would you most commonly find salivary duct calculi?

Answer 20

submandibular duct

Question 21

what is the rx for calculi in the submandibular duct?

Answer 21

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

Question 22

what is the rx for salivary calculi in the parotid duct?

Answer 22

superficial parotidectomy