Salivary Gland Enlargement

Question 1

Give some reasons there may be changes in salivary gland size

Answer 1

Viral inflammation
- mumps or HIV

Secretion retention
- mucocele
- duct obstruction

Gland hyperplasia
- sialosis or sjogrens

Question 2

Give some symptoms of mumps

Answer 2

Headache
Joint pain
Nausea
Dry mouth
Facial and neck swelling
Pyrexia over 38 degrees
Mild abdominal pain

1/3 no symptoms

Symptoms worse with age

Question 3

How can HIV affect salivary glands?

Answer 3

HIV can be a cause of salivary swelling

Unexplained salivary swelling

May have no HIV symptoms first

Generally does not improve with treatment

Question 4

What is a mucocele? Where often found?

Answer 4

Obstruction of minor salivary gland
- swelling of mucosa
- filled with saliva

Often on lower lip or junction of hard and soft palate

Question 5

What is subacute obstruction?

Answer 5

Salivary duct obstruction / swelling associated with meals
- increases as salivary flow starts
- reduces when salivary flow slows

Can be progressive over weeks and eventually becomes fixed

Question 6

What can cause subacute obstruction?

Answer 6

Sialolith - salivary stone

‘Mucous’ plugging

Ductility damage due to chronic infection and scarring

Duct stricture
- damage of low grade infection to the duct

Question 7

How investigate subacute obstruction?

Answer 7

Low dose plain radiography
- lower true occlusal

Sialography
- when infection free

Question 8

How manage subacute obstruction?

Answer 8

Surgical stone removal if practical

Consider gland removal if fixed swelling