Facts about Salivary Glands?

Salivary glands are many exocrine glands that secretes salivary substances into the epithelial surface of the oral cavity through salivary duct.

There are 3 major salivary glands:

Parotid gland also known as serous glands
Submandibular gland also known as mixed gland
Sublingual gland also known as mucous gland

How do we diagnose the stone in the salivary glands

Computed tomography (CT scan)
MRI scan
Radionuclide Imaging
Sialochemistry
Sialography
Ultrasonography, it will detect stone of diameter>2mm

If any of the problems involved in salivary glands lead to infection like Sialadenitis & Sialolithiasis.

Sialadenitis:

If there’s any infections seen in the major salivary glands then it is called Sialadenitis. It is seen mainly in the Parotid gland.

Causes of Sialadenitis:

Microorganisms like staphylo/streptococcus infection.
Decrease host resistance.
Poor oral hygiene.
Dehydration.

Symptoms of Sialadenitis:

Unilateral enlargement and tenderness of gland.
Elevation of ear lobes.
Redness of overlying skin.
Generalized symptoms like cervical lymphadenopathy.
Facial pain and swelling in paranasal epistaxis.
Might lead to nasal obstruction in the nasal cavity.
May lead to ill fitting dentures in old people.

Treatment for Sialadenitis:

Maintenance of oral hygiene.
Intake of soft diet.
Maintenance of electrolyte balance.
Surgical drainage of infection if the above measures fails.

Sialolithiasis or Sialolith:

It is a calcified organic matter that forms within the secretory system of the major salivary glands. Sialolith consists of hydroxyapatite,calcium phosphate and carbon, with a trace amount of magnesium, potassium chloride and ammonium. It is seen mainly in submandibular gland and parotid gland.

Causes of Sialolithiasis:

Inflammation by microorganisms.
Irregularities in the duct system.
Prolong use of anticholinergic medications.

Symptoms of Sialolithiasis:

Acute painful and intermittent swelling seen.
Eating initiates salivary gland swelling.
Stone totally or partially blocks flow of saliva causing salivary pooling within ductuall system.
Stasis of saliva may lead to infection, fibrosis and gland atrophy.
Fistula, sinus tract or ulceration may occur over stone in chronic cases.
Soft tissue surrounding the duct may show edema and inflammation.

Treatment for Sialolithiasis:

In acute phase-supportive treatment - analgesic, antibiotic, hydration and antipyretic treatment will help, In exacerbation

Surgical intervention drainage or removal of stone
Stones at or near the duct are removed transorally by milking the glands
Deeper stones are removed by surgery or Sialendoscopy
Smaller stones are removed by gently massaging the glands.
Sailogogueso, moist heat and increased fluid intake may also promote passage of stone
Large sialolith are surgically removed

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