Salivary

Salivary Gland Infection (Sialadenitis)

About

Salivary gland infections in adults are common. They can occur spontaneously, but are most often due to obstruction of the gland (via stone or tumor), poor oral hygiene, or dehydration, which may thicken the secretions within the gland.

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Causes

Medications, which dry the mucosal membranes, such as cold medications and antidepressants, are particularly notorious for causing salivary gland infections.

Symptoms

Salivary gland infections present with painful swelling of the gland.They can come on very quickly and very dramatically.

Treatment

The treatment of bacterial infections of the salivary glands is antibiotics, hydration, massage and sialogogues. Salivary glands can also be infected by viruses (for example mumps), as well as unusual organisms such as tuberculosis Salivary Gland Cysts. Salivary gland cysts are most common in the smaller glands. Many people develop mucoceles, which are small cysts in the minor salivary glands. These are most common in the lips. A particular type of salivary cyst is called a ranula. It develops in the sublingual gland and can balloon up the floor of mouth or less commonly but more seriously invade the soft tissue of the neck and cause swelling in the upper neck. Salivary cysts can sometimes successfully be drained but the majority of time should be excised.

Salivary Stones

About

Salivary stones are deposits of calcium within the salivary glands. They are most commonly found in the submandibular glands but also may occur in the parotid glands.

Causes

Dehydration, which results in a thicker and more mucoid saliva, increases the risks that one may form stones.

Symptoms

Salivary gland stones will present with obstruction of the flow of saliva. This will cause acute painful swelling while eating or even thinking about food. The swelling will then sometimes gradually or rapidly decrease as the saliva leaks around the stone. Occasionally, these glands will become infected due to the blocked nature of the duct.

Treatment

Patients with salivary gland stones are frequently good candidates for sialoendoscopy to remove the stone. On occasion, they require open removal of the stone and unfortunately some of these patients will require excision of the infected gland.

Salivary Gland Tumors

About

Salivary gland tumors are neoplastic growths in the salivary gland. Some of these tumors are benign and others are cancerous. All salivary glands can develop tumors but the larger the gland the more common tumor formation is. All salivary glands can develop tumors, but the larger the gland the more common the tumor is benign. For example, 75% of parotid gland tumors are benign while only 25 to 30% of sublingual gland tumors are benign. Even benign salivary gland tumors should usually be excised because excision becomes more difficult as they grow larger, and a small percentage of benign tumors will turn into malignant cancers.

Treatment

Salivary gland tumors usually present with painless growths in the salivary gland. A slowly growing painful mass is suspicious for a malignant tumor. Benign salivary gland tumors and some malignant tumors are successfully treated with surgery alone. Many malignant salivary gland tumors require radiation therapy in addition to surgery. Diagnosis of salivary gland tumors is made by physical examination, by imaging such as CT or MRI scans, and by fine needle aspiration.