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Non-neoplastic salivary diseases - Coggle Diagram
Non-neoplastic salivary diseases
Sialosis (Idiopathic)
Diffuse symmetrical enlargment
Soft, painless gland
In association with : ch dis., pregnancym alcoholism, nutritional dis.,or some drugs as iodoine, contaceptives
Inflamatory
Viral parotitis
Bilat. painful swelling with fever in a child
Self limiting
Acute bacterial sialadenitis
Atiology
Predis. factors: eldery, postop., immunicompromised and ductal obstruction
Causative org. : Staph
C/P
Gland swelling
Marked pain
Increase with talking and mastication
Throbbing pain if abccess
Examination
Diffuse enlarged gland
Fever
Red skin
Firm tender swelling
No flactuation on abccess due to tough fascia
Gentle pressure may produce pus
If ductal stone may be felt by bimanual examination
TTT
Prophylactic
Oral hygiene
Hydration
Curative
Clindamycin
48 hours no response = abccess
Inv.
US
Swollen, tender gland with pus or stone formation
Recurrent subacute & ch. sialadenitis
Due to salivary gland abnormality : stone, autoimmune or degenerative dis.
His. of pain and increase in size during eating
Solitary swelling can't be rolled over mandible edge
Bimanual palpation shows swelling fills floor of mouth
Autoimmune dis. (Sjogren's syndrome)
Alone or in conjugation with other autoimmune dis.
Pathology
Incidence 1% & F:M 10:1
Recurrent salivary and lacrimal inflamations
Early: Lymphocytic infiltration & epith. hyperplasia
Late: Multifocal ductal fibrous stricture & Prgressive acini atrophy
20% >>> Non-Hodgikin's lymphoma
C/P
Recurrent attacks of salivary & lacrimal glands acute inflammation
Oral & eye dryness
Ascending bacterial infection may complicate due to xerostomia
INV.
US : enlarged glsnds with dilated obstructed ducts
Sialography : snowstorm appearance
TTT
Ample fliuds
Slivary massage
Artificial tears
Steroids
Abs
Strict follow up ( lymphoma detection)
Salivery stones (sialolithiasis)
INV.
US
Stone & dilated duct proximally
Plain X ray
radio opaque shadow in 80% of cases
Ascending sialography
Rarely needed
Pathology
Common in xerostomia or ch. sialadenitis
Stones impacted at gland hilum or duct
80% in submand. gland due to:
viscid, high ca secretion
independent duct
TTT
Large stones : lithotripsy
If failure:
Ductal stones >> surgical removal
Glandular stones >> sialadenectomy
Impacted stones : trans ductal endoscopic extraction
Small stones : pass spontaneously
C/P
Recurrent attacks of painful swelling
Precipitated by eating
Releaved spontaneously few hours after meals
May express pus with gentle compression
Sialectasis (degenerative dis.)
Etiology
Sialolithiasis
Autoimmune sialadenitis
1ry
Bacterial sialadenitis
Pathology
Intraglandular duct tree stenotic areas with segments of dilatations
Ductal obstruction >> progressive acinar atrophy >> xerostomia
Associated recurrent ascending bacterial infection
Recurrent infection >>> further damage of gland
Investigations
US >> Ductectasia
Ascending sialography >> Snow storm app.
TTT
Cause ttt
Sialadenectomy