ORHL2102 Week 11 Salivary Glands

Stensen’s Duct

Parotid duct, 5cm long, opens opposite upper second molar, serous

Wharton’s Duct

Submandibular superficial and deep, opens into anterior floor of mouth, serous and mucous

Bartholin’s Duct

Sublingual glands, superior surface of mylohyoid muscle, mucous

Von Ebner Glands

Minor salivary glands surrounding circumvalate papillae, associated with taste, serous

Contents of mucous fluid

antiseptic enzymes (lysozymes), immunoglobulins, inorganic alts, proteins and glycoproteins

Contents of serous fluid

Transparent pale yellow, protein and water, amylase enzyme for digestion of carbohydrates

Atresia

Major salivary gland duct is blocked or absent, causing a retention cyst

Accessory Parotid Tissue

Developmental extra parotid salivary tissue located on masseter muscle, drains into Stensen’s duct

Sialadenitis

Painful inflammation/infection of salivary glands

Acute Bacterial sialadenitis/parotitis

Bacteria or infection ascends up duct, usually in parotid and suppurative, most common in patients with Sjogrens and immunocompromised

Chronic Bacterial sialadenitis/parotitis

Bacteria or infection ascends up duct, usually in submandibular and associated with salivary calculus, most common in patients with Sjogrens and immunocompromised

Mumps/Paramyxovirus

Viral infection, incubates for 2-3 weeks with a fever, malaise, followed by painful swelling of salivary glands lasting approx 7 days

Salivary calculus - sialoliths

Most common cause of duct obstruction mainly affecting submandibular gland, causing swelling and pain particularly at meal times

Extravastation cyst

Results from trauma to overlying mucosa

Mucous Retention Cyst

Forms in the floor of mouth due to obstruction, also mucocele

Mucocele features

Moveable and painless, soft, round, pearly/semi-clear surface, bluish in colour, 2-10mm in size

Ranula

Cyst that forms from sublingual gland. “rana” = frog. Increases in size with food, unilateral soft tissue mass, often bluish in colour

Primary Sjogrens Disease

Chronic auto-immune disease, destruction of lachrymal and salivary glands - xerostomia and xephthalmia

Secondary Sjogrens Disease

Xerostomia, xephthalmia, autoimmune CT condition like rheumatoid arthritis

Sialorrhea

Drooling - involuntary loss of saliva from mouth, commonly caused by neurological disorders (Parkinson’s, cerebral palsy) or impaired swallowing

Pleomorphic Adenoma

A mixed salivary gland tumour, can have pre-malignant tendencies, typically in parotid gland and in minor glands in palate. Caused by neoplastic proliferation of glandular cells.

Occlusal radiograph

Most effective x-ray to view intradcutal stones

Sialaography

Use of contrast dye to visualise salivary ducts and glands on x-rays