Ear, Nose and Throat (ENT) and Head and Neck
Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh in 300 Essentials SBAs in Surgery, 2017
The patient has chronic sialadenitis. Chronic sialadenitis most commonly occurs because of obstruction of the submandibular duct due to stone formation. Approximately 80% of all salivary stones affect the submandibular gland, and this is due to the increased viscosity of secretions; the majority (approximately 70%) of submandibular stones are radio-opaque and can be visualised on plain X-rays, unlike the majority of parotid duct stones. Management is surgical laying-open of the submandibular duct or excision of the duct and gland. Sjögren’s disease is an autoimmune condition in which there is destruction of the lacrimal and salivary glands; this leads to xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). Submandibular tumours typically present as slow-growing, painless swellings within the submandibular triangle. Acute sialadenitis is commonly caused by bacteria and results in pain, erythema, tenderness and swelling of the gland; purulent discharge is usually expressed from the submandibular duct.
Non-Neoplastic Salivary Gland Diseases
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
The benefits of sialography for the diagnosis of acute suppurative sialadenitis remain unclear. Some authorities suggest that such investigation is contraindicated (probably when there is notable disease), while others suggest that it may resolve any causative ductal stricture. Sialography may reveal areas of ductal stricture and sialectasis, the latter are most likely with recurrent disease. Scintiscanning is generally unhelpful but may sometimes reveal the underlying cause (e.g. poor salivary gland function). Ultrasound scanning is useful as it may identify sialoliths, ductal anomalies, fluid collections and parenchymal disease of probable Sjögren’s syndrome or HIV disease. Additional cross-sectional imaging may be essential if abscess formation is suspected.
Ultrasound imaging, including ultrasound-guided biopsy
John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan in Operative Oral and Maxillofacial Surgery, 2017
Acute salivary gland inflammation occurs in response to suppurative sialadenitis and viral infection. Inflammation causes gland hypertrophy and hypo-echogenicity, i.e. the salivary glands lose their normal bright echotexture. Ultrasound can be used to exclude abscess formation and may demonstrate hyper-reflective microbubbles of gas in suppurative sialadenitis, which usually affects a single gland, along with reactive nodes. In the case of abscess formation in acute suppurative sialadenitis, ultrasound- guided percutaneous drainage combined with antibiotic therapy may avoid surgical intervention.
Ectopic tonsil in the floor of the mouth: A case report
Published in Acta Oto-Laryngologica Case Reports, 2021
Clinical examination revealed about 1 cm large non-fluctuating, non-tender evenly soft submucosal mass on the floor of the mouth, just under and to the left side of the tongue, near the left sublingual salivary gland as seen in Figure 1. The rest of the floor of the mouth was palpated without remark. No other enlarged mass was palpable in the head and neck region. Preliminary diagnosis set as sialoadenitis of the left sublingual salivary gland or mucocele. It was decided to stick the lump with a fine needle. A small amount of yellowish secret was aspirated and sent only for bacteriological examination. Unfortunately, the aspirated secret was not examined by the pathologist and no cytological analysis was done. The patient was told that in case the mass begins to fill up, surgical removal under local anesthesia would be suggested. The culture report revealed sparse growth of the Actinomyces hongkongensis bacteria which may be part of the normal flora but can sometimes cause abscess and in rare cases even actinonomycosis. Resistance and sensitivity patterns revealed that the bacteria were sensitive to both benzyl penicillin and clindamycin antibiotics. Even though the patient had no clinical signs of infection, but since there was a certain risk for the bacteria to cause abscess, she was put on treatment with antibiotic, clindamycin for two weeks according to the recommendation of the infection’s clinic.
Incidence and risk factors for radioactive iodine-induced sialadenitis
Published in Acta Oto-Laryngologica, 2020
Alvaro Sánchez Barrueco, Fernando González Galán, Ignacio Alcalá Rueda, Jessica Mireya Santillán Coello, María Pilar Barrio Dorado, José Miguel Villacampa Aubá, Manuel Escanciano Escanciano, Lucía Llanos Jiménez, Ignacio Mahillo Fernández, Carlos Cenjor Español
Nevertheless, there have been reports of several complications of 131I such as transient neck pain and edema, pulmonary, gastrointestinal, and hematopoietic systems dysfunction; gonadal damage, conjunctivitis, alopecia, as well as secondary tumors [2]. Salivary gland disorders are one of the most frequent among the possible side effects of this treatment [2], usually manifesting as swelling of the affected salivary gland. One such disorder, sialadenitis, is characterised by episodic or permanent inflammation of one or more salivary glands with associated pain, usually in submandibular and/or parotid gland. This inflammation can present alongside xerostomia, taste alteration, and salivary gland infection. Sialadenitis associated with 131I treatment is referred to as radioactive iodine-induced sialadenitis (RAIS). Sialadenitis can occur within the first 48 h after radio iodine treatment, or late, up to 3 to 6 months after the therapy has been received.
Prevotella species as oral residents and infectious agents with potential impact on systemic conditions
Published in Journal of Oral Microbiology, 2022
Eija Könönen, Dareen Fteita, Ulvi K. Gursoy, Mervi Gursoy
Sjögren’s syndrome (SS), an autoimmune disease, typically affects the salivary and lacrimal glands. In a Norwegian study, the composition of the salivary microbiome was examined in 45 women divided into primary-SS (p-SS), dry mouth (non-SS), and healthy control groups [167]. The mean relative abundance of the genus Prevotella was around 30%, and P. histicola, P. melaninogenica, and P. salivae were among the core microbiomes in all three groups. However, dysbiotic shifts in the salivary microbiota, including significantly reduced abundance of P. pallens and detection of P. nanceiencis and P. intermedia, were observed only in women with disturbed saliva secretion [167]. In a Korean study, comparing 25 women with p-SS and 25 controls with or without dry mouth, P. melaninogenica was highly associated (OR 22.4) with Sjögren’s syndrome [168]. Labial salivary gland biopsies with focal sialoadenitis revealed a high presence of bacteria, including P. melaninogenica, within the ductal cells and in the area of infiltration. In order to understand the bacterial involvement in the etiopathogenesis of Sjögren’s syndrome and in the functional and phenotypic changes in salivary glands, the authors used a human submandibular gland tumor cell model [168]. According to the results, P. melaninogenica increased and P. histicola decreased interferon (IFN)-λ production. Moreover, P. melaninogenica induced the deregulation of submandibular gland cells.
Related Knowledge Centers
- Inflammation
- Mumps
- Pus
- Sialolithiasis
- Staphylococcus Aureus
- Sublingual Gland
- Parotid Gland
- Submandibular Gland
- Salivary Gland
- Sjögren Syndrome