Whether you suffer from a stone in your mouth or you have a tumor, there are several diseases and treatments available to treat your condition. If you have any questions about these disorders or your options, you can contact a healthcare provider for more information.
Inflammatory disease
Typically, inflammatory diseases of the salivary glands are caused by infection. However, there are also some noninfectious inflammatory disorders that can cause chronic inflammation of the glands. These include infections, tumors, and certain neoplasms.
Infective inflammatory diseases of the salivary glands tend to affect the major salivary glands, including the submandibular and the parotid glands. These glands produce over 95% of the saliva in the mouth.
Typical symptoms of these infections include fever, fatigue, and pain. They are usually caused by bacteria, but may also be viral. In these cases, treatment is usually hydration and antibiotics. If the infection becomes severe, you might need to be hospitalized for intravenous antibiotics. Generally, viral infections are not as painful as bacterial infections, but they do have some general discomfort.
Some noninfectious inflammatory disorders can also cause swelling of the salivary glands. These conditions can include autoimmune disorders, tularemia, sarcoidosis, and diabetes mellitus. These conditions can occur in children or adults and are often accompanied by chronic inflammation.
Ultrasound (US) is a widely used diagnostic tool for inflammatory disease of the salivary glands. It is considered to be a first-line diagnostic tool in inflammatory diseases of the major salivary glands and has become even more valuable due to technical advances.
Acute bacterial sialadenitis is characterized by an enlargement of the glands with diffuse painful erythema. It may also be associated with a stone in the salivary duct. A fine needle biopsy can help diagnose this condition. It can also be used to drain an abscess. Alternatively, antibiotics such as amoxicillin-clavulanate or clindamycin can be prescribed.
Acute bacterial sialadenitis can be difficult to diagnose. The patient’s symptoms can include a sudden onset of pain and fever, as well as swelling. A final diagnosis can be made after blood tests and histopathologic investigations.
Tumors
Despite the wide variety of histopathological diagnoses, neoplasms of the salivary glands account for less than 1% of head and neck lesions. Surgical excision of these tumors is the standard treatment, although additional treatments are also necessary for some cases.
The primary goal of this study was to evaluate the accuracy of the preoperative clinical diagnosis of salivary gland tumors. Information from the patient’s history, physical examination, and imaging studies were combined in the final clinical judgment. This method of analysis led to a 67% overall accuracy.
The study used a retrospective chart review from 1990 to 1997. Three hundred twenty-four consecutive cases of salivary gland masses were evaluated. Of these, 192 hemangiomas, 89 lymphangiomas, and 43 solid masses were included. The final clinical judgment was not completely reliable in submandibular tumors. However, hemangiomas were tallied for relative incidences only.
The most common benign tumor was Warthin’s tumor, followed by pilomatrixoma and mixed tumor. Pleomorphic adenomas made up 15.2% of all benign lesions. The remaining malignant tumors were mucoepidermoid carcinomas, acinic cell carcinoma, and neurofibromas.
The majority of malignant parotid tumors were diagnosed by surgery. A partial or complete parotidectomy was performed in the vast majority of cases. The remaining cases required radiation therapy and chemotherapy.
The most common benign per salivary mass was a pilomatrixoma, which was found to have skin involvement. The majority of patients with benign per salivary tumors did not have a difference in age between them and those with malignant per salivary tumors.
Several factors may contribute to the high rate of cancerous tumors in the salivary glands. Exposure to cigarette smoke, alcohol, and tobacco, for example, may increase the risk. A tumor that has metastasized can spread to the liver and bones.
Stones
Symptoms of stones in salivary glands include pain or swelling in the mouth, fever, and bad taste. They can also cause infection in the affected gland.
Some people may have several stones that are stuck in the duct system. This can lead to recurring infections. If this is the case, your doctor may prescribe antibiotics to treat the infection.
A less invasive procedure called sialendoscopy can be used to remove stones in the salivary gland. This procedure is performed under local anesthesia. During the procedure, your doctor will use a small camera and several micro instruments to look at the duct system. The stones are then removed by using a basket-like tool.
Surgical removal of the whole salivary gland is another method. If you have recurrent stones, this option may be the best choice. However, if your stones have not become infected, you can try to treat them conservatively. This may involve a heat application or a gentle massage to the salivary gland.
If your stone is only partially blocking the duct, you can try to flush it out by drinking lots of fluids. This may help reduce the pain and swelling. If your stone is larger, your doctor may need to use a local anesthetic to numb the area.
The main cause of salivary gland stones is a blockage of the flow of saliva. This can lead to an infection known as sialadenitis. It is usually caused by bacteria.
A special X-ray or ultrasound can reveal the location of the stones. This can give your doctor a better diagnosis. In addition, your doctor can perform a CT scan or an MRI to see whether the stones are causing a problem.
Necrotizing sialometaplasia
Despite its rarity, necrotizing sialometaplasia is a very important condition. It is characterized by an inflammatory ulcerative lesion of the minor salivary glands. It usually manifests as an ulcer and should be diagnosed early to prevent unnecessary surgery.
It is most commonly found in the hard palate, although it has also been reported to affect the nasal cavity and upper airway. It can occur de novo or in association with other benign lesions.
It occurs mainly in men, with a male-to-female ratio of about two to one. The average age of the patient at diagnosis is 46 years. The patient had a history of palatal swelling three weeks before his biopsy.
After his biopsy, histopathological findings showed diffuse acini necrosis, squamous metaplasia of the ducts, and intraglandular ductal dilatation. In addition, some acini were transformed into canalicular structures.
The patient was treated with an antimicrobial agent, chlorhexidine rinses, and the administration of paracetamol for pain. He was also advised to maintain good oral hygiene. He was also tested for human immunodeficiency virus. His plasma regain was negative.
The prognosis is excellent. The healing time is usually six to ten weeks. Once the condition is cured, it usually does not recur. However, it can occasionally recur after full recovery.
The triggering factors of NS are unknown. Some believe it is caused by a direct injury to the salivary gland tissue, or by ischemic events. Others think it is related to systemic diseases with significant vascular alterations. In fact, the most widely accepted triggering factor is an ischemic event.
The onset of NS may be spontaneous, or it may be triggered by local trauma. It should be suspected if a patient presents with a large, deep, ulcerative, or erythematous lesion.
Treatment
Despite their low prevalence, salivary gland disorders are a medical condition that often requires treatment. They may present with acute symptoms, such as swelling and pain, or with chronic problems, such as reduced saliva flow. They can be caused by infection or obstruction.
Infections are characterized by a fever, pain, and swollen glands. They can spread to the bloodstream or the bones of the face. Some people may need to take antiviral medications and receive antibiotics. If an abscess forms, it will need draining. If the infection does not clear up on its own, the doctor may order an imaging test, such as MRI or PET-CT. The results can help identify the site of the infection and its stage.
Sialendoscopy is a minimally invasive endoscopic procedure that is used to diagnose and treat salivary gland diseases. It involves stretching a duct to the mouth, inserting an endoscope, and then navigating to the hilum of the gland.
This method is a useful technique for the diagnosis and treatment of salivary gland disorders in children. The Johns Hopkins Salivary Gland Center provides patients with state-of-the-art evaluation and treatment.
Infections, stones, and obstructive lesions can cause blockages in the salivary ducts, resulting in swelling of the gland. Depending on the type of infection, some people may need surgery to repair the narrowed tubes.
Malignancies can also obstruct the salivary ducts, causing inflammation. This can cause a condition called xerostomia, which means dry mouth.
This condition can be treated by using a combination of ultrasound, fine needle biopsy, and other methods. MRI and PET-CT can also be used to look for masses. The goal of treatment is to rule out other conditions that might be contributing to the swelling.
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U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
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Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/
