Salivary Gland Disorders

mucocele

• due to trauma

• especially in children

• lower lip most common

• bluish, translucent hue

which salivary gland issues did we discuss which are NON NEOPLASTIC?

• mucocele/ranula

• salivary duct cyst

• cheilitis glandularis

• necrotizing sialometaplasia

• nicotine stomatitis

• sialolithiasis

• LESA

• mumps

  etc…

what 3 salivary gland issues did we discuss which are BENIGN and NEOPLASTIC

• pleomorphic adenoma

• warthin’s tumor

• canalicular adenoma

what are the MALIGNANT NEOPLASTIC salivary gland disorders?

• mucoepidermoid carcinoma

• polymorphous adenocarcinoma

• adenoid cystic carcinoma

• carcinoma ex-pleomorphic adenoma

what is a mucocele caused by?

trauma, severance of the duct and spills mucin

a mucocele on the FOM is called

ranula

a mucocele on the ventral tongue is called

blandin-nuhn

mucocele treatment

excision of lesion and minor salivary glands

characteristics of a ranula

• floor of mouth, sublingual gland

• lateral to midline

• increases in size before and during meals

what is a plunging ranula?

mucin dissects through mylohyoid muscle and process a neck swelling (bull frog)

salivary duct cyst

“mucus retention cyst”

• true cyst

• upper lip

difference between mucocele, ranula, and salivary duct cyst?

mucocele : lower lip, kids, no epi lining

ranula : floor of mouth, sublingual

salivary duct cyst : upper lip, adults, epithelial lining

cheilitis glandularis

rare inflammatory condition of minor salivary glands

• lower lip

• openings of ducts are dilated and inflamed

necrotizing sialometaplasia

uncommon lesion locally destructive inflammatory condition of salivary gland

• ischemia leading to infarction of glands

• hard palate

• mimics malignancy

what is the clinical appearance of necrotizing sialometaplasia?

begins as painful, non-ulcerated swelling and develops over 2-3 weeks with necrotic tissue sloughing and a non-painful ulcer

nicotine stomatitis

• pipe and cigar contact

• NOT precancer

• inflamed salivary glands = volcano like papules with red central dots

sialolithiasis

calcified structures that develop in the ductal system

• commonly submandibular gland

• swelling or episodic pain during chewing

• radiopaque, seen with occlusal x ray

sialadenosis

enlargement of salivary gland due to a non-infectious cause

• usually bilateral parotid

• caused by stone, systemics, or recent surgery (surgical mumps)

what are the systemic conditions that can cause sialadenosis?

diabetes, malnutrition, alcoholism, bulimia, sjogren’s

also can be caused by recent surgery because pt kept without food or drink for awhile

sialadenitis

acute or chronic inflammation of salivary glands

• mainly submandibular

• caused by infection such as bacterial or mumps

lymphoepithelial sialadenitis (LESA)

autoimmune condition

• parotid and lacrimal glands

• sjogren’s association

• females

main concern of lymphoepithelial sialadenitis (LESA)?

progression to lymphoma

sialorrhea

• excess saliva

• due to local irritants, meds, or poor muscular control

what is pilocarpine?

sialogogue which stimulates saliva in xerostomia

xerostomia

• extreme dry mouth

• gland hypofunction, meds, radiation, Sjogren’s can all cause

• clinically fissured tongue, ropey, foamy saliva

what are some meds that can cause xerostomia?

1. antihistamines

2. anticholinergics

3. antidepressants

4. sedatives & anxiolytic

5. antihypertensives

what are some side effects of xerostomia?

1. frothy saliva

2. infections (candida)

3. ulcers

4. rampant caries

5. halitosis

how do you treat xerostomia?

• good hydration

• sialogogues, sugar free lemon drops

• salagen (pilocarpine) and evoxac (cevimeline)

sjogren’s syndrome

autoimmune condition with decreased saliva and tears from unknown cause

1. primary affects salivary and lacrimal glands without any other autoimmune diseases

2. secondary accompanies another autoimmune disease

exophthalmia and keratoconjunctivitis

dry eyes and damage to eyes

sjogren’s syndromes buzz words

• females

• bilateral parotid swelling

• dry mouth, dry eyes

what is a concern for sjogren’s?

CONCERN for MALT lymphoma, non hodgkins B cell lymphoma

frey syndrome “auriculotemporal syndrome”

facial flushing and sweating along the distribution of the auriculotemporal nerve during mastication due to nerve damage

what is mumps caused by ?

viral, paramyxovirus

mumps is also called …

epidemic parotitis

mucocele image

ranula image

salivary duct cyst / mucus retention cyst image

cheilitis glandularis image

necrotizing sialometaplasia image

nicotine stomatitis image

sialolithiasis image

sialadenosis image

sialadenitis image