DISORDERS OF THE SALIVARY GLANDS

Dr. Shahzadi Tayyaba Hashmi

DNT 243

Disorders of the salivary glands

Saliva is produced by three paired major salivary glands, the parotid, submandibular and sublingual glands, and numerous minor salivary glands which are present throughout the oral mucosa

Any of these salivary glands may be affected by disease The most important disorders of salivary glands are 1) Mucocele2) Mucous retention cysts3) Mucous extravasation cysts4) Sialoadenitis5) Sjogren’s syndrome6) Salivary glands neoplasms

1) Mucocele

Mucocele is a clinical term given to a cystic swelling usually caused by trauma affecting the minor salivary glands

Clinical features: Commonly occurs on the lower lip

and cheeks of young individuals They appear as sessile ( broad-based) blue swellings Patient often give a history of a rapid increase in size

following trauma

Histological types of mucocele

Two histological types are recognized,a) Mucous retention cystsb) Mucous extravasation cysts

A) Mucous extravasation cysts

Most Common type Occurs as a result of trauma to the minor

salivary gland duct Trauma causes the duct to rupture and saliva

spills into the tissue rather than the oral cavity

Healing cannot takes place

B) Mucous retention cysts

Relatively rare as compared to mucous extravasation cysts

Caused by trauma but the duct becomes blocked usually by scar tissue

Saliva is unable to enter the oral cavity Duct swells up like a balloon filled with water

Treatment:• The treatment of

both lesions is

excision including the

underlying

minor salivary glands

2) SIALOADENITIS

Inflammation affecting the salivary glands is known as Sialoadenitis

Etiology: Infections ( mumps) Ductal obstruction( A salivary stone or calculus is a common cause of

obstruction and submandibular gland is most often affected)

Clinical features: Patient complains of pain and swelling of the

submandibular gland particularly just before or at meal times because the increased outflow of saliva is blocked

2) SIALOADENITIS

Treatment: Stone is removed if it is accessible but

sometimes it is necessary to remove the gland as well

3) SJOGREN'S SYNDROME

Autoimmune disease Affect salivary glands, lacrimal glands and

many other organs in the body

Etiology: Unknown Patients have circulating auto antibodies in their

blood and their salivary glands are destroyed by numerous lymphocytes which infiltrate into the glands

This caused lack of saliva and dry mouth ( xerostomia)

Types of Sjogren's syndrome

1. Primary Sjogren's syndrome, in which patients have dry eyes and a dry mouth ( xerostomia)

2. Secondary Sjogren's syndrome, in which patients have another autoimmune disorder such as rheumatoid arthritis, in addition to dry eyes and dry mouth

Treatment: Artificial saliva Pilocarpine to enhance salivary secretion

4)Salivary glands neoplasms

May be benign or malignant Majority of salivary gland neoplasms are

benign and the most common type is Pleomorphic adenoma

Malignant neoplasms are rare but mucoepidermoid carcinomas and adenoid cystic carcinomas are most common

Difference between benign and malignant neoplasms of

salivary glands

Benign tumours Malignant tumours

Slow growth of lesions Rapid growth of lesions

Well-defined margins, which are easy to feel

Indistinct margins and difficult to feel

If they arise from minor salivary glands in the oral cavity, they do not ulcerate the oral mucosa

If they arise from minor salivary glands in the oral cavity, they often ulcerate through the oral mucosa

Painless Painful