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The salivary glands
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Imaging does not necessarily change the decision for surgery, as parotidectomy is still regarded by many as ‘the grand biopsy’, but it can help stratify urgency, guide approach and highlight potentially challenging cases such as deep lobe tumours. In submandibular and minor salivary gland disease, imaging is essential.
Gastrointestinal tract and salivary glands
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The presence of saliva within the oral cavity is necessary to initiate the digestive process and it also acts as an important lubricant of the intraoral mucosa. Imaging has a role in evaluating the extent of salivary gland disease in patients who present with a dry mouth and those patients that present with pain prior to eating. It is important that the clinician takes a thorough history of the condition in order to prescribe the most relevant investigations for the patient. A variety of radiographic examinations are available to the clinician that include contrast sialography, ultrasonography, CT, MRI and radionuclide salivary studies.
The ENT history and examination
Published in Rogan J Corbridge, Essential ENT, 2011
Sore throat and tonsillitis along with intra-oral lesions such as ulcers on the tongue are the most common conditions of the mouth seen in ENT practice. It is important to ascertain a good general medical history, since a wide variety of systemic conditions such as anaemia and human immunodeficiency virus (HIV) infection can present with oral manifestations. In the case of swellings within the mouth, an increase in size or pain with eating is suggestive of salivary gland disease.
A rare case of epithelial-myoepithelial carcinoma arising ex pleomorphic adenoma of the lacrimal gland: case report and review of the literature
Published in Orbit, 2022
Nicholas Van Rooij, Alexander R. Newman, Vipul Vyas, Timothy J. Sullivan
Local recurrence is common in non-lacrimal disease, with rates reported to be 35% to 40% occurring even decades after initial management from salivary gland disease.4 Gonςalves and colleagues (2017) describe a case of EMC ex pleomorphic adenoma presenting 14-years following en bloc resection of the lacrimal gland pleomorphic adenoma.10 To date, there has been no disease-specific mortality from lacrimal gland EMC and the recurrence rates from the 9 reported cases thus far is 0% (Table 1). However, this observation is limited due to the short duration of follow-up in lacrimal EMC (3–36 months) and the small number of identified cases. Due to the high recurrence rate of EMC in general, lifelong surveillance is advised.1 No nodal or distant metastases have been reported in lacrimal EMC. Prognostic information has been extrapolated from larger EMC series and population data from salivary gland tumours with reported 5, 10, and 20-year survival rates of 72.7%-93.5%, 59.5%-90.2%, and 38.3%, respectively.3,4,14
A novel diagnostic technique of measuring labial minor salivary gland secretions using sodium fluorescein dye: Implications for patients with dry eyes
Published in Seminars in Ophthalmology, 2022
This prospective study was approved by the institutional ethics committee (LEC-12-20-556) and adhered to the tenets of the Declaration of Helsinki. Forty healthy volunteers (males and females; aged 10–60 years) and consecutive patients diagnosed with SS and SJS presenting to dry eye clinic were enrolled in this study. Healthy controls were divided into four groups based on the age. All subjects were healthy, had no symptoms of dry mouth, and were free of any dentures or salivary gland diseases. None of them were on any systemic medications. The diagnosis of SJS was made as per the criteria reported by the authors earlier.12 The diagnosis of SS was made as per ACR-EULAR 2016 diagnostic criteria. Patients with SS and SJS underwent detailed slit-lamp examination, dry eye diagnostics [ocular surface disease index (OSDI), Schirmer I test, and fluorescein staining], and slit-lamp photographs of the ocular surface. Patients were asked if they experience any dry mouth-related symptoms. Subjects were asked not to eat, drink, or smoke for at least 60 min before collection. Patients with SJS who have undergone mucous membrane grafting were excluded. The saliva flow rates were measured from the lower labial MSGs in all subjects. An experienced researcher (S.S) performed the test after obtaining informed consent.
Pharmacotherapy of oral mucosal manifestations of chronic graft-versus-host disease: When? What? and How?
Published in Expert Opinion on Pharmacotherapy, 2020
The oral cavity and salivary glands are involved in 25–80% of chronic GVHD patients [1]; and the oral cavity may be the only site with manifestations of chronic GVHD [2]. Moreover, oral lesions could persist after aggressive systemic therapy [3]. Chronic GVHD may cause an erosive lichen planus-like oral mucosal disease (Figure 1) or present as a superficial mucocele, pyogenic granuloma, and verruciform xanthoma [4]. In addition, individuals post HSCT, and especially chronic GVHD patients, have a higher risk of developing oral squamous cell carcinoma [5]. Patients may also suffer from an altered sense of taste (dysgeusia), from Sjögren-like salivary gland disease that may cause hyposalivation and xerostomia, or from sclerodermatous disease that may affect the tongue and peri-oral tissues restricting function and limiting mouth opening [6]. These manifestations may result in symptoms (mild discomfort to intense pain), impair oral function, nutrition, and socialization, leading to poor oral health and reduced quality of life, and may also be life-threatening [7]. This concise Invited Editorial will focus on the management of oral mucosal lichenoid lesions in chronic GVHD.