SALIVARY GLAND DISORDERS - PDF Document

Presentation Transcript

  1. SALIVARY GLAND DISORDERS DR. ARJUN DASS PROF. & HEAD

  2. INTRODUCTION • Four main salivary glands • Two parotid glands • Two submandibular glands • Multiple minor salivary glands in the upper respiratory track

  3. ANATOMY

  4. IMPORTANT STRUCTURES THAT PASS THROUGH PAROTID GLAND • Facial nerve • Terminal part and branches of external carotid artery • Maxillary artery • Superficial temporal artery • Retromandibular vein • Intra parotid lymph nodes

  5. SUBMANDIBULAR GLAND

  6. SALIVARY GLANDS LESIONS • Congenital • Inflammatory • Viral • Bacterial • Traumatic • Neoplasm • Benign • Malignant

  7. INFLAMMATORY DISORDERS • Viral infections (Mumps) • acute painful parotid swelling • children • airborne droplet infection • ex on meals • Complications • Orchitis ,oophritis, pancreatitis ,SNHL, meningoencephlitis

  8. TREATMENT • Analgesics • Fluid intake • Life long immunity

  9. BACTERIAL INFECTION • Acute Suppurative Sialadenitis • May involve parotid or submandibular gland • Ascending infection • Staph aureus , strep. • Dehydrated old / young children

  10. ACUTE SUPPURATIVE SIALADENITIS Clinical Features : • Malaise, pyrexia , cx LAP • Examination : pus from duct opening Management : • USG • I.V Antibiotics • Drainage

  11. CHRONIC SIALADENITIS • Chronic infection of salivary gland can lead to firm, mild enlargement of the gland with repeated acute infection • More in parotid gland followed by submandibular gland • History of recurrent mildly painful enlargement of gland. Massage of gland produces scanty secretions at the opening of the duct

  12. MANAGEMENT • USG • Papillotomy • Removal of calculus • Antibiotic • Massage of the gland • Total gland excision • Tympanic neurectomy

  13. SALIVARY GLAND TUMOURS • Tumours of salivary glands represent a complex and histopathologically diverse group of tumour • Diagnosis and management is complicated by the fact that they are in frequent • Making up only 1% of head and neck tumour • Proper management require and accurate diagnosis by the pathologists and physicians

  14. Salivary gland tumours Benign malignant • Parotid 80-90% 10-20% • Submandibular 50% 50% • Sublingual 5% 95% • Minor 10% 90%

  15. PAROTID TUMOURS • Most common site of salivary neoplasm • Mainly arise from superficial lobe • Slow growing painless mass below or infront of pinna • Deep lobe tumours present as parapharyngeal mass • Dysphagia / snoring / mass in oropharynx

  16. CLASSIFICATION OF PAROTID TUMOURS • Adenoma pleomorphic / warthin, adenolymphoma • Carcinoma acinic cell ca / adenoid cystic ca adenocarcinoma / scc

  17. PLEOMORPHIC ADENOMA • Most common benign tumour • Can arise from parotid, submandibular or other salivary gland • In the parotid it usually arises from tail • Slow growing tumour • Seen in 3rdor 4thdecade • More in female • Both epithelial and mesenchymal elements are seen

  18. DIAGNOSIS • History • Clinical examination • FNAC • Ultrasonography • CT Scan • MRI

  19. TREATMENT • Surgical Excision • Superficial parotidectomy • Total parotidectomy with preservation of facial nerve

  20. WARTHIN’S TUMOUR • More common in male (5:1) • Seen between 5th& 7thdecade • Mostly involve tail of parotid • Bilateral in 10% • May be multiple • Rounded, encapsulated at time cystic • Treatment : Superficial parotidectomy

  21. CLINICAL FEATURES OF MALIGNANT SALIVARY TUMOURS • Facial palsy • Rapid increase in size • Hard mass / ulceration • Cervical lymphadenopathy

  22. SIALADENOSIS Non inflammatory swelling affecting salivary glands 1. Diabetes mellitus 2. Alcoholism , pregnancy 3. Bulemia 4. Drugs 5. idiopathic •

  23. DEGENERATIVE CONDITIONS Sjogren syndrome • Autoimmune • Progressive destruction of salivary and lacrimal glands • xerostomia • Primary • Secondry connective tissue disorders

  24. DISEASES OF SUBMANDIBULAR GLAND • Inflammatory conditions Viral Bacterial • Obstructive calculus trauma • Tumours

  25. THANK YOU