Salivary Gland Enlargement Flashcards

1
Q

What are the 3 reasons for change in gland size?

A
  • Viral inflammation
  • Secretion retention
  • Gland hyperplasia
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2
Q

What can cause viral inflammation in glands?

A
  • Mumps
  • HIV
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3
Q

What can cause secretion retention in glands?

A
  • Mucocele
  • Duct obstuction
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4
Q

What can cause gland hyperplasis?

A
  • Sialosis (unknown cause)
  • Sjogrens syndrome
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5
Q

What are the symptoms of mumps?

A
  • Headache
  • Joint pain
  • Nausea
  • Dry mouth
  • Mild abdominal pain
  • feeling tired
  • Loss of appetite
  • Pyrexia of 38C or above
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6
Q

What type of virus is mumps and how is it spread?

A
  • Paramyxovirus
  • Droplet spread
  • Incubation 2-3weeks
  • Symptomatic txt only
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7
Q

What is the type of enlargement seen in salivary glands due to HIV?

A
  • Lympho-proliferative enlargement
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8
Q

When you have unexplained salivary swelling what disease can this be associated with?

A
  • HIV
  • Pt may present with no HIV symptoms but also can present with HIV diagnosis
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9
Q

What is a Mucocele?

A
  • Swelling in the mucosa filled with saliva
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10
Q

Where can you find a mucocele?

A
  • In the duct
  • Extravasated in to the tissues (mucous extravasation system)
  • Common to find in lower lip and soft palate (areas of trauma)
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11
Q

What will a pt complain of for a mucocele?

A
  • Recurrent swelling which may burst in mater of days
  • Salty taste when bursts
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12
Q

When should a mucocele be removed by oral surgeon?

A
  • If mucocele becomes hard but will not cause damage if left alon until child becomes of age to get LA instead of GA to remove
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13
Q

What is a Subacute obstruction?

A
  • Swelling associated with the major glands (usually submandibular as duct is longer than parotid)
  • Usually associated with duct blockages either by stones or mucous plugging
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14
Q

With a subacute obstruction what will the pt complain of in regard to the swelling?

A
  • Swelling associated with meals
  • Swelling increases when ot eating as salivary flow starts
  • Swelling decreases when salivary flow stops after meal finished
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15
Q

What is the progression rate of subacute obstruction?

A
  • Slowly progressive over weeks
    -Eventually becomes fixed and painful as gland is blocked and saliva cant escape
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16
Q

In a subacute obstruction what is the difference in outcome between submandibular and parotid?

A

Usually duct blockage in submandibular
- Usually duct structure in parotid

17
Q

What are some causes of subacute obstruction?

A
  • Sialolith (stones)
  • Mucous plugging
  • Ductal damage from chronic infection
18
Q

What does this image show?

A
  • Lower true occlusal radiograph
  • Acceptable
  • Sialoltih (stones)
19
Q

What investigations can be done for subacute obstruction?

A
  • Low does plain radiography
  • Lower true occlusal
  • Sialography (only when infection free as can further push mucous plug into gland and cause worse blocakge)
  • isotope scan if gland function uncertain
  • Ultrasound assessment of duct system
20
Q

What does this image show?

A
  • OPT
  • Shows right side submandibular
21
Q

What does this image show?

A
  • Duct stricture using sialogram
  • Stone in the parotid duct causing a stricture
  • Infection most likely to have cause stone and stricture
22
Q

What does this image show? How does this occur? What childhood disease may cause this?

A
  • Duct dilatation
  • Defects prevent normal emptying
  • Micro0orgs grow and lead to persisting and recurrent sialadenitis
  • Gland function gradually lost and persisting infections lead to gland removal
  • Recurrent Parotitis of childhood
23
Q

What is the management of Subacute obstruction?

A
  • Surgical sialolith removal
  • If no stone present then use Sialograpahy (washing effect)
  • Consider gland removak if fixed swelling
24
Q

what is the outcome of subacute obstruction if not managed?

A
  • Reformation of stone/obstruction
  • Deformity of duct - can lead to stasis and infection
  • Gland damage with low salivary flow, ascending infection
25
Q

What is Sialosis?

A
  • Major salivary gland enlargement with no obvious glandular cause
  • Shows bilateral enlargement with no focal enlargement and generalised diffuse change

Perhaps
- Alcohol abuse
- Cirrhosis
- Diabetes Mellitus
- Drugs

26
Q
A