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Flashcards in chpt 11 Deck (41):
1

Persistent enlargement in the submandibular gland

Kuttner's tumor

2

 All ages

Fluctuant to firm

Lower lip 60%

Superficial form post. BM

Mucocele

3

Epithelial lined cavity
May represent duct obstruction
Adults; major glands parotid; minor glands FOM, BM and lips

Salivary duct cyst

4

Mucocele or mucus cyst - treatment

Remove surgically with adjacent glands

5

mucocele, floor of the mouth

Raises tongue
Worries patient
May rupture

 

Ranula

6

Mucous escape reaction in FOM
Plunging ranula when spilled mucin dissects mylohyoid 

ranula

7

treatment for ranula

removal of feeding sublingual gland and/or marsupialization

8

salivary stone symptoms

2 days duration
On/off swelling
Progressive pain
Worse at mealtime
Temperature at examinatio

9

Most often ductal system of submandibular gland
Major gland sialoliths cause episodic swelling especially at mealtime
Salivary gland endoscopy and lithotripsy

sialolithiasis

10

Sialagogues, moist heat and increased fluid intake may promote passage of stone
Minor gland involvement surgical removal; sometimes may need to remove major gland

sialolithiasis

11

Infectious and non-inf. causes
Mumps and surgical mumps (NPO and atropine)
Staphlococcus aureus; acute bacterial sialadenitis (ABS)
Non-infectious; Sjogren Syn. sarcoidosis, radiation therapy and various allergens

Sialadenitis

12

Acute bacterial sialadenitis most common parotid; bilateral 10-25%
Affected gland swollen, painful and overlying skin erythematous
Low-grade fever, possibly trismis and purulent discharge from duct orifice

sialadenitis

13

Sialography sialectasia proximal to obstruction
In submand. G. persistent enlargement (Kuttner tumor)
Subacute necrotizing S. involves minor glands of hard and soft palate represents painful intact nodule

Sialadenitis

14

involves minor glands of hard and soft palate represents painful intact nodule

subacute necrotizing sialadenitis

15

3 subtypes of cheilitis glandularis

1. Simple
2. Superficial suppurative → BAELZ’S disease
3. Deep suppurative → Cheilitis glandularis apostematosa

16

• Rare inflammatory condition of minor salivary glands
• Lower lip with swelling and eversion as a result of hypertrophy and inflammation of the glands. The openings of minor salivary ducts are inflamed and dilated and pressure on the glands may produce mucopurulent secretions from the ductal openings
• Affects middle aged and older MEN

cheilitis glandularis

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•Tx of persistent cheilitis glandularis with actinic damage

VERMILLIONECTOMY

18

what is the danger of cheilitis glandularis?

o 18-35% of cases are associated with SCC due to actinic change

19

• excessive salivation

Sialorrhea

20

  • location irritations such as apthuous ulcers and new dentures
  • GERD
  • Heavy metals and rabies
  • Medications: lithium and cholinergic agonists

Causes of Sialorrhea

21

o Episodes of excessive salivation lasting 2-5 minutes
o Episodes are associated with a prodrome of nausea or epigastric pain

idiopathic paroxysmal siallorhea

22

o Anticholinergic medications
o Transdermal scopolamine (use in ppl > 10 yrs)
o Surgery if the problem is neuromuscular
o Control GERD if this is a factor

treatment for sialorrhea

23

• Drooling problem in pts who are mentally retarded, have a neuromuscular disorder like cerebral palsy (cp) or who have had surgical resection of the mandible; NOT due to overproduction of saliva but due to poor neuromuscular control

sialloehea

24

Treatment of acute sialadenitis

Antibiotics and rehydration

25

How differentiate sialadenitis from salivary gland tumor

Sialdenitis will have pain

26

First, Second, and Third leading cause of Xerostomia

DRUGS

27

What’s the anti rule for xerostomia

if it’s an anti drug (e.g. antidepressant) it causes xerostomia

28

Treatments for Xerostomia

Biotene
Prevident 5000
Pilocarpine 5 mg tabs

29

What infection is seen with Xerostomia

candidiasis
Cervical and root caries

30

This is a cause of Xerostomia that is normally a unilateral swelling of the parotid gland

 Benign lymphoepithelial lesion

31

What is the characteristic histo associated with Benign Lymphepithelial Lesion

epimyoepithelial islands

32

Symptoms associated with Sjogren syndrome or any xerostomia

red tender oral mucosa
Angular cheilitis
Candidiasis
Cervical Decay
Difficulty swallowing
Altered taste
Retrograde bacterial sialadenitis

33

Fruit laden branchless tree

 

Sialographic look or Sjogren syndrome

34

tear test for Sjogren Syndrome

 

Schirmer test (<5mm tears for 5 min = Keratoconjuctivitis sicca)

35

NON INFLAMMATORY disorder characterized by salivary gland enlargement, especially parotid, usually do to some underlying systemic problem

Sialadenosis/Sialosis

36

Systemic conditions associated with Sialadenosis

Diabetes melitis Malnutrition
Alcoholism
Bulimia

37

Locally destructive inflammatory condition of salivary glands caused by ischemia that leads to local infarction. The problem is it mimics a malignant process clinically and microscopically

Necrotizing Sialometaplasia

38

What is one way to differentiate Necrotizing Sialometaplasia from Oral Cancer

Cleaner borders around the lesion (cancer has ragged borders)

39

Where is Necrotizing Sialometaplasia commonly found

Posterior Palate salivary glands (squamous cell carcinoma rare on palate)

40

Treatment for Necrotizing Sialometaplasia

Biopsy and no treatment, will resolve in 5-6 weeks

41