DISORDERS OF THE SALIVARY

GLANDS

Dr. Shahzadi Tayyaba Hashmi

shahzadi@inaya.edu.sa

• Saliva is produced by three paired major salivary glands, the parotid, submandibular and sublingual glands, and numerous minor salivary glands which are present throughout the oral mucosa

• Any of these salivary glands may be affected by disease• The most important disorders of salivary glands are 1) Mucocele2) Mucous retention cysts3) Mucous extravasation cysts4) Sialoadenitis5) Sjogren’s syndrome6) Salivary glands neoplasms

DISORDERS OF THE SALIVARY GLANDS

• Mucocele is a clinical term given to a cystic swelling usually caused by trauma affecting the minor salivary glands

Clinical features:• Commonly occurs on the lower lip

and cheeks of young individuals• They appear as sessile ( broad-based) blue swellings• Patient often give a history of a rapid increase in size following

trauma

1) MUCOCELE

• Two histological types are recognized,

a) Mucous retention cysts

b) Mucous extravasation cysts

HISTOLOGICAL TYPES OF MUCOCELE

• Most Common type• Occurs as a result of trauma to the minor salivary

gland duct• Trauma causes the duct to rupture and saliva spills

into the tissue rather than the oral cavity

A) MUCOUS EXTRAVASATION CYSTS

• Relatively rare as compared to mucous extravasation cysts• Caused by trauma but the duct becomes blocked usually by

scar tissue• Saliva is unable to enter the oral cavity• Duct swells up like a balloon filled with water

Treatment:• The treatment of

both lesions is

excision including the

underlying

minor salivary glands

B) MUCOUS RETENTION CYSTS

• Inflammation affecting the salivary glands is known as Sialoadenitis

Etiology:• Infections ( mumps)• Ductal obstruction

( A salivary stone or calculus is a common cause of obstruction and submandibular gland is most often affected)

Clinical features:• Patient complains of pain and swelling of the submandibular

gland particularly just before or at meal times because the increased outflow of saliva is blocked

2) SIALOADENITIS

Treatment:• Stone is removed if it is accessible but sometimes it is

necessary to remove the gland as well

2) SIALOADENITIS

• Autoimmune disease• Affect salivary glands, lacrimal glands and many

other organs in the body

Etiology:• Unknown• Patients have circulating auto antibodies in their blood

and their salivary glands are destroyed by numerous lymphocytes which infiltrate into the glands

• This caused lack of saliva and dry mouth ( xerostomia)

3) SJOGREN'S SYNDROME

1. Primary Sjogren's syndrome, in which patients have dry eyes and a dry mouth ( xerostomia)

2. Secondary Sjogren's syndrome, in which patients have another autoimmune disorder such as rheumatoid arthritis, in addition to dry eyes and dry mouth

Treatment:• Artificial saliva• Pilocarpine to enhance

salivary secretion

Types of Sjogren's syndrome

• May be benign or malignant• Majority of salivary gland neoplasms are benign

and the most common type is Pleomorphic adenoma

• Malignant neoplasms are rare but mucoepidermoid carcinomas and adenoid cystic carcinomas are most common

4)Salivary glands neoplasms

Benign tumours Malignant tumours

Slow growth of lesions Rapid growth of lesions

Well-defined margins, which are easy to feel

Indistinct margins and difficult to feel

If they arise from minor salivary glands in the oral cavity, they do not ulcerate the oral mucosa

If they arise from minor salivary glands in the oral cavity, they often ulcerate through the oral mucosa

Painless Painful

Difference between benign and malignant neoplasms of salivary glands