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Salivary Gland Diseases

Salivary Gland Diseases. Sialadenitis. Inflammation of salivary gland Bacterial Viral (Mumps) Allergic Irradiation. Infective. Non-infective. Bacterial sialadenitis. Usually secondary to localized or systemic predisposing factors

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Salivary Gland Diseases

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  1. Salivary Gland Diseases

  2. Sialadenitis • Inflammation of salivary gland • Bacterial • Viral (Mumps) • Allergic • Irradiation Infective Non-infective

  3. Bacterial sialadenitis • Usually secondary to localized or systemic predisposing factors • Reduction in salivary flow due to localized (calculus) or systemic casus (Sjögren’s) • Low immunity, elderly, debilitated & dehydrated patients

  4. Bacterial sialadenitis • Clinical picture: • Sudden onset (acute) • Gland is painful , swollen & indurated • Erythematous overlying skin • Purulent discharge from orifice

  5. Bacterial sialadenitis • Treatment • Antibiotics after culture and sensitivity • Increase hydration • Improve oral hygiene • Remove predisposing factor if possible (calculus) • Excision of severely damaged gland (chronic/ recurrent)

  6. Chronic form might follow resolution of acute infection or start as chronic • Recurrence if inadequately treated or persistent predisposing factor

  7. Mumps • Mumps is a viral infection that primarily affects the parotid glands . • Caused by the paramyxo virus.

  8. Mumps- Symptoms • Incubation period – 2- 3 weeks • Swollen, painful salivary glands on one or both sides. • Pain with chewing or swallowing • Fever • Weakness and fatigue

  9. Mumps- Complications • Potentially serious but rare • Orchitis • Pancreatitis • Meningitis/ meningoencephalitis • Unilateral SN loss

  10. Diagnosis • Elevated serum and urinary amylase • Elavated serum Ig G and Ig M levels

  11. Mumps- treatment and prevention • Treatment: • Mumps is a self-limiting disease . • Treated with bed rest . • Analgesics : • Prevention: • The most common preventive measure against mumps is immunization with a mumps vaccine.

  12. Chronic recurrent sialedinitis • Usually parotid • Recurrent bacterial infection • Acute episodes – enlarged and tender parotids • Between episodes – enlarged and firm • Good oral hygiene, sialogogues

  13. Sialectasis • Dilatation of ductal system  stasis of secretion • Sialography • Congenital • Associated with granulomatous/ autoimmune disease

  14. Sialolithiasis • Formation or presence of a calculus or calculi in a salivary gland. • It is most commonly seen in the submandibular gland and duct (about 80% of cases), then the parotid gland and duct

  15. Sialolithiasis • Symptoms: • May be asymptomatic • Dull pain from time to time over the affected gland • Swollen . • Pain with chewing or swallowing

  16. Sialolithiasis • Treatment: • Intra oral removal • Excision of the gland

  17. Tuberculosis • Non tender mass • Fistula • Surgical excision of involved part • ATT

  18. Sarcoidosis (Uveoparotid fever) • Chronic granulomatous disorder affecting several organs • Lungs • Skin • Eyes • Parotid gland

  19. HIV-associated salivary gland disease • HIV patients usually develop salivary gland problems and xerostomia • Swelling of parotid might be caused by: • Sjogren-like condition • Kaposi’s sarcoma • Lymphoma • Viral infection • Chronic parotitis

  20. Sjögren’s syndrome • Chronic autoimmune disease destructing exocrine glands • Unknown etiology • 1SS= lacrimal & salivary gland dysfunction • 2SS= 1SS + connective tissue disease • More common in female • Middle - Old age group

  21. Primary SS / Benign lymphoepithelial lesion of parotid / Mikulicz’s disease. • Mostly parotid gland is affected • Persistent / intermittent gland enlargement • bilateral, non-tender, firm, and diffuse swelling • Xerostomia & xerophthalmia • B cell lymphomas

  22. Secondary SS - Clinical picture • Keratoconjunctivitis sicca • Xerostomia • Connective tissue disorder • Bilateral swelling of parotids • More in females

  23. Diagnosis • Raised ESR • Positive rheumatoid factor • Positive antinuclear antibodies

  24. Sialorrhea (ptyalism) • Rare complaint caused by: • Hypersecretion • New intraoral prosthesis • Infected or ulcerative lesions • Neuromuscular dysfunction • Cerebral palsy, Parkinson’s disease & epilepsy • Decrease swallowing induces drooling • Infants • Pt with neuromuscular disease

  25. Sialorrhea (ptyalism) Treatment: • Remove underlying cause if possible • Anticholinergic drugs • Reassurance • Speech therapy

  26. Frey’s Syndrome • Complication of parotid surgery • Sweating and flushing of pre auricular skin during mastication • Faulty innervation of sweat glands by parasympathetic secretomotorfibres of parotid

  27. Treatment of Freys Syndrome • Reassurance • Tympanic neurectomy • Placing fascia lata between skin and underlying fat

  28. Thankyou

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