Salivary Gland Disease

Diseases	Details
Xerostomia	means dry mouth and can be related to diseases such as Sjogren's syndrome and diabetes as well as use of antidepressants, antihistamines, anxiety and old age as well as mouth breathers and dehydration. Those who have had local radiation for malignancy can also be affected. Rehydration where appropriate. Review medications. Regular oral fluids. Loss of saliva impairs talking and swallowing as it lubricates lips and tongue and food and also increases dental caries and oral disease.
Parotitis	Most commonly seen with the young with mumps (orchitis too) but in xerostomia or associated with salivary duct stones and in the elderly bacterial infection with streptococci or staphylococci can occur requiring antibiotics. The gland is enlarged and warm and tender. There may be a bad taste and halitosis and there is usually other intercurrent illness e.g. stroke which has impaired oral hygiene.
Salivary duct calculi	Most often seen with the submandibular gland. New techniques now allow removal of stones. Classically there is swelling and enlargement of the glands before and when eating as saliva production increases.
Tumours	70% of salivary gland tumours are benign. Tumours of the smaller submandibular and other smaller salivary glands are more likely to be malignant. Parotid tumours, on the whole, are more likely to be benign. A parotid swelling with a VII nerve palsy is highly suggestive of a malignant tumour. Examine thoroughly for the involvement of cervical nodes. The commonest tumour is the benign pleomorphic adenoma which tends to lie in the superficial part of the parotid with the facial nerve sandwiched in between the deep and superficial layers. It can usually be removed by a superficial parotidectomy but any residual tumour can lead to local recurrence.
Pleomorphic adenoma	benign, Warthin's tumour (adenolymphoma) benign and bilateral in 10%
Malignant	Mucoepidermoid carcinomas, Squamous carcinomas, Adenocarcinomas, Adenoid cystic carcinomas, Lymphomas