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Salivary Glands (Viva (Salivary Gland Neoplasms (Features (80% in the…

- - - - 80% in the parotid gland
      - 80% benign: 80% are pleiomorphic adenomas
      - Only 60% of submandibular gland tumours are benign
    - - Benign
        
        Pleiomorphic adenoma: 80%
        
        <50yrs
        
        Adenolymphoma: Warthin’s tumour
        
        50yrs
        Smoking is important risk factor
      - Malignant
        
        1st: Mucoepidermoid
        
        2nd: Adenoid cystic
        
        Malignant Features
        
        Facial nerve palsy
        Rapid growth and pain
        Hyperaemic, hot skin
        Hard consistency
        Fixity to skin or underlying muscle
  - - - Benign
        
        Superficial: superficial parotidectomy
        
        Deep: total parotidectomy
      - Malignant
        
        Total parotidectomy ± adjuvant radiotherapy
      - Complications
        
        Immediate
        
        Facial nerve injury
        
        Reactionary haemorrhage
        
        Early
        
        Temporary facial weakness: neuropraxia
        
        Salivary fistula
        
        Loss of pinna sensation: greater auricular nerve
        damage.
        
        Late: Frey’s Syndrome (gustatory sweating)
        
        Facial sweating while eating
        
        Re-innervation of divided sympathetic nerves by
        fibres from the secretomotor branch of
        auriculotemporal branch of CNV3
- - - - Parotid or submandibular?
      - Bilateral or unilateral?
    - - Stenson’s duct opposite the 2nd maxillary molar
      - Wharton’s duct adjacent to the frenulum linguae
      - Inflammation, stone, pus