Salivary gland
General information:
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| Salivary glands: Parotid gland, submandibular gland and sublingual gland |
The glands are found in and around your mouth and throat. We call the major salivary glands the parotid, submandibular, and sublingual glands.
They all secrete saliva into your mouth, the parotid through tubes that drain saliva, called salivary ducts, near your upper teeth, submandibular under your tongue, and the sublingual through many ducts in the floor of your mouth.
Besides these glands, there are many tiny glands called minor salivary glands located in your lips, inner cheek area (buccal mucosa), and extensively in other linings of your mouth and throat. Salivary glands produce the saliva used to moisten your mouth, initiate digestion, and help protect your teeth from decay.
As a good health measure, it is important to drink lots of liquids daily. Dehydration is a risk factor for salivary gland disease.
Salivary gland infection
Infection of the salivary glands may be either viral or bacterial in origin. Viral sialadenitis may be caused by coxsackie virus, echo virus, cmv or mumps virus. Mumps virus it the most common cause of viral salivary gland infection. It causes acute, nonsuppurative enlargement of both parotid glands with low grade fever, malaise and anorexia. Its course is usually mild.
This is in contrast to bacterial sialadenitis, also known as suppurative sialadenitis or surgical parotitis. It occurs in dehydrated, debilitated patients. There is a rapid onset of swelling and fever, with erythema and warmth over the affected gland. You can sometimes see pus coming from the duct. Staph. Aureus is the most common organism. Treatment is IV fluids, augmented penicillins and sialagogues, and possibly surgical drainage.
Salivary ductal stone (Sialolithiasis)
Sialolithiasis is stones in the salivary gland or duct. 90% of salivary stones occur in the submandibular gland, and 10% occur in the parotid gland. 70 - 90% of all stones are radiopaque; that is, they are white on plain films. However, only 10% of parotid stones are radiopaque. Sialolithiasis is associated with sudden pain or swelling with eating, relieved by a sudden gush of fluid into the mouth. Sialolithiasis may predispose the patient to repeated episodes of bacterial sialadenitis.
Salivary gland tumor
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| Left parotid mass |
Neoplasms of the salivary glands usually occur in the major salivary glands, with 80% occurring in the parotids, and almost 20% occurring in the submandibular glands. Parotid tumors are benign 80% of the time, and malignant 20%. One-half of submandibular tumors are malignant. 80% of minor salivary gland tumors are malignant. Minor salivary glands are located in the lips, buccal mucosa and palate. The most common site of minor salivary glands is the hard palate.
Benign epithelial neoplasms include pleomorphic adenoma, which is also known as mixed tumor. It is the most common benign salivary gland tumor. Warthin’s tumor, also known as papillary cystadenoma lymphomatosum, is common in elderly men, and can be bilateral. Monomorphic adenoma is another benign neoplasm of the salivary glands. These tumors present as discrete painless, slowly enlarging masses, usually in the superficial lobe of the parotid gland. There is no facial nerve weakness. Treatment is superficial parotidectomy.
Main symptoms indicating malignancy
o Rapid growth or episodes of growth (exception is adenoid cystic carcinoma which grows very slowly)
o Pain
o Firm infiltration, occasionally ulceration of skin or mucosa, poor mobility of tumor
o Facial paralysis in parotid gland
Central neck |