Salivary glands

Disorders of secretion

Xerostomia (i.e.: dry mouth): This is a symptom of several diseases. Causes can be: medications (i.e.: antihypertensive, antidepressant, analgesics, diuretics, transhistamines), stress/fear/anxiety, Sjiogren’s syndrome (dry eyes + mouth) – causes fibrotic glands, irradiation sialadenitis (loss of secretory cells).

Sialorrheoa (ptyalism): increased salivary flow. Cause: neurological, acute inflammation of oral cavity.

Salivary calculi: Stones in the salivary glands (i.e.: submandibular & parotids, not sublingual) or salivary ducts (i.e.: submandibular & parotids). M:F = 2:1. Most common beyond 2^nd decade of life.

Salivary cysts: Three types ≫ 1) mucous extravasation (too much production), 2) mucous retention (blockage in ducts), 3) ranula (similar to 1&2)

Inflammatory disorders

Acute sialadenitis (inflammation of salivary gland): inflammation most often affects parotid gland (CT scan shows enlarged parotids). Usually caused by bacterial infections due to dehydration of oral cavity (xerostomia). Causative organisms: Strep viridans, Staoh aureus.

Chronic sialadenitis (as above): This occurs chronically due to unresolved acute sialadenitis, or due to strictures or stones. Eventually, inflammation leads to fibrosis of salivary gland.

Chronic recurrent parotitis: Clinically, you get tender parotid glands during GI examination. Usually seen in children and female adults. The parotid ducts are proliferating & dilated, and you get acinar atrophy and fibrosis.

Specific bacterial and granulomatous lesions: GATSS.

Viral infections: CM

Sjogren’s syndrome

This is characterised by dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia). It occurs because the lacrimal and salivary glands are attacked by lymphocytic and other immune cells. 90% are F > 50yrs. Commonly associated with Rheumatoid arthritis, SLE & scleroderma.

Tumours of salivary gland

Category: Pathology Notes