Salivary gland disorders Flashcards
What are the cx of parotid sx?
branches of facial nerve. Zygomatic is most impt -> responsible for eyelid closure -> dysfunction -> exposure keratitis. Marginal mandibular 2nd most impt
Frey’s syndrome: aberrant regeneration of the PSNS supply following surgery (-> gustatory swelling). Higher risk if skin is very thin (after surgery). Sweat when eating.
Salivary leak: after Sx, some of the ducts are exposed and continue to produce saliva, hence it can leak out.
what are the causative organisms of sialadenitis?
Mumps (paramyxovirus infection): most common cause of bilateral parotid gland enlargement, occurs mainly in children
- Signs: systemic upset, swelling & pain (due to stretching of parotid capsule)
- Submandibular gland involvement possible but rare
HIV infection 🡪 cystic enlargement of major salivary glands
TB 🡪 affects intraparotid lymph nodes or the gland itself (rare)
NTM infections sometimes seen as a cold abscess of the lymph nodes adjacent to the submandibular or parotid gland
What are the symptoms of acute sialadenitis? Risk factors? treatment?
Acute infection of the parotid or submandibular gland presenting with pain & swelling +/- fever
Examination: swollen & tender gland, pus from duct openings
Treatment: high-dose antibiotics, rehydration, oral hygiene
What are the symptoms of chronic sialadenitis? treatment?
Most often affecting submandibular gland
Symptoms: pain & swelling in episodes or transiently after meals
Chronic changes and scarring in the architecture of the gland
Treatment: antibiotics for acute episodes, surgical excision
What are the clinical features of sialolithiasis? What are the investigations? How is it treated?
Formation of calculi within salivary glands, often occurs in combination with chronic sialoadenitis. Mostly in submandibular gland – due to its thicker, more calcium-rich secretions.
Clinical presentation: post-prandial swelling & pain, may be in association with repeated infections
Stone may be palpated in the floor of the mouth if it migrated into the submandibular duct
Investigations: CT, X-ray, sialogram (radio-opaque dye)
Treatment: oral fluids, sialogogues, surgical excision of the stone or gland if severe
What are examples of benign salivary gland tumour? how do they present?
Present as slow-growing, painless masses, facial or other nerve palsy not common
Examination: smooth, subcutaneous swelling with no attachment to skin
Most common: pleomorphic adenoma – usually arises in the parotid
Warthin’s tumour/adenolymphoma – usually arises in the parotid (tail)
How would a malignant salivary gland tumour present?
Present as a rapidly growing swelling, often with pain and involvement of other structures e.g. facial nerve in parotid malignancy.
Malignant tumours more common in the sublingual and minor salivary glands (dispersed throughout oral and nasal cavities) than in the parotid
