Thyroid, Salivary Gland & Sialendoscopy Conditions
Thyroid, Salivary Gland & Sialendoscopy Procedures
Salivary Gland Infections & Inflammation
Infections And Inflammations Of The Salivary Glands
There are a number of conditions of the Salivary Glands caused due to either infections or other inflammatory conditions.
The prevalence of salivary gland diseases depends on various causes such as viral, bacterial, rarely fungal or obstruction to the ducts which may cause painful swelling or obstruction, affecting their functions.
Dryness Of Mouth (Xerostomia)
Dryness of the mouth can be temporarily caused by anxiety and effect of certain drugs that decrease the volume and output of saliva. Certain conditions like Sjogrens syndrome, Sarcoidosis, Neurological conditions, Vitamin deficiency, Anaemia etc can cause long term dryness of the mouth. Radiotherapy given to the head and neck for cancers can also result in dry mouth.
What symptoms could you get due to altered salivary flow in the mouth:
The lips are often cracked, peeling and dry, bad breath. The tongue may be smooth and reddened, cracked or fissured. You may have burning sensation of oral mucosa, lips or tongue or oral ulcers. There is an increase in erosion and caries of the teeth. The saliva may be sticky with difficulty in speaking and swallowing. Fungal and Bacterial infections of the mouth may occur often.
Treatment of dry mouth and associated problems:
Routine and regular Dental care and maintenance of oral hygiene and routine evaluation by ENT Head Neck surgeon and Dentist is advised. The mouth should be hydrated regularly using water or lozenges, artificial salivary substitutes, lubricants such as lanolin based product Vaseline, olive oil, vitamin E or lip balm, oral gels prescribed by your clinician after thorough evaluation.
Inflammatory Of Salivary Glands (Sialadenitis)
Inflammation implies redness, pain and swelling of the gland. Some types of Inflammation of the Salivary Glands can be due to Infections from Viruses or Bacteria. Others may be non-infection related.
The Parotid salivary glands are most commonly affected in adolescents and in children, in debilitated adults, or patients with certain medications. Submandibular glands are mostly affected in middle aged individuals.
Infections Of The Salivary Gland
Acute bacterial sialadenitis: The Parotid gland is the most common salivary gland involved in acute sialadentitis due to bacterial infection.
Mumps / acute viral sialadenitis: Viruses causing sialadenitis include Paromyxoviruses (MUMPS), Coxsackie virus. After the initial acute period of 3-4 days the inflammation of the salivary gland starts reducing by the end of 1st week and the patient returns to normal by 10 days. Pancreatitis, acute meningitis and sterility are some of the complications of mumps.
Abscess related to salivary gland infection: Abscess is an extremely painful and debilitating infection of salivary gland mostly after bacterial causes. This results in collection of pus (abscess) in the gland. This requires extensive antibiotic therapy and surgical incision and drainage of the pus, with excision of the gland if warranted at a later date.
Other Viral associated Sialadenitis : Other Viral infections like Hepatitis and HIV may cause mild swelling of the parotid gland with minimum or no symptoms of dry eyes and dry mouth.
What are the symptoms of Salivary Gland Infection ?
The person may have a low to high grade fever with generalised weakness , difficulty opening the mouth, sudden pain at the angle of the jaw. One may have a swelling on one side with enlargement of the gland, which is warm and painful on touch and pressure. There may be pus discharge at the opening sites of the salivary gland duct in the mouth.
What is the treatment for Salivary Gland Infections ?
A lot of the time the treatment is supportive and symptomatic. We advise the use of agents to stimulate production of Saliva, maintaining adequate hydration and good oral hygiene. Pain killers and Anti-inflammatory medication are prescribed. In bacterial infections, we will usually prescribe certain antibiotics. In case there is suspicion of an abscess formation, we may ask for imaging such as an Ultrasound examination , and if confirmed surgical aspiration or drainage may be advised to evacuate the pus.
The use of Mumps vaccination (MMR) may decrease the incidence of this infection and is considered as preventive measure.
Non – Infection Inflammation Of The Salivary Glands:
Some non-infection related conditions can result in inflammation of the salivary glands.
Decreased salivary flow can be secondary to medications, dehydration or debilitating conditions, due to sialolithiasis (stones) or strictures(narrowing) within the ductal system.
Salivary Stones (Sialolithiasis) : Sialoliths or salivary stones are calcified, grainy, or stony concretions in the salivary glands causing obstructive or inflammatory conditions of the gland.
Causes leading to the salivary stone formation may be related to disturbed pH of saliva, abnormalities in the sphincter mechanism related to salivary duct opening and external or intraluminal obstruction of the duct. Read more about Salivary Stones here.
Acute postoperative parotitis: This occurs after a major surgical procedure where in the patient depends only on intravenous fluids. Patients are often on certain pre-anaesthetic medications for drying the secretions, and this may contribute to dryness of mouth and subsequent inflammation of parotid salivary glands.
Radioactive iodine therapy induced sialadenitis: The use of high dose of oral Iodine 131 in treatment of certain thyroid carcinomas can adversely affect the salivary glands leading to inflammation.
Sialadenosis: This is an non-inflammatory and non-tumour enlargement of salivary glands which more commonly affecting the parotid salivary glands. This may occur in conditions like Diabetes mellitus, Acromegaly, Hypothyroidism, Pregnancy, Anorexia nervosa/ Bulimia, Chronic alcoholism, due to Psychiatric medications or certain antihypertensive drugs.
The person has a slowly progressing bilateral (rarely unilateral) swelling of parotid salivary glands which may be asymptomatic.
Traumatic mucocele and ranula
The rupture of a salivary gland duct can occur mostly due to trauma, resulting in spillage of saliva into the surrounding tissues. This forms a soft fluid filled structures on the lip or within the oral cavity.
A Mucocele appear as thin walled lesion which is fluctuant, and the most common site of occurrence is on the lower lip.
A Ranula is a type of mucocele which grows in the floor of the mouth usually from the sublingual gland, is unilateral and is larger than a mucocoele.
These often require some form of surgical intervention; the type of procedure depends on the size, site and nature of the swelling.