Salivary Glands Diseases

Salivary glands are organs that are distributed around the oral cavity and produce saliva.

They are distinguished in major and minor. The parotid, submaxillar and sublingual salivary glands are considered to be the major ones. Minor salivary glands are around 400-500. Saliva is a liquid essential for digestion, speech, swallowing and for the maintenance of oral health.

The quantity of saliva produced daily is normally about 1-1.5 liters. In the salivary glands, the most common pathological conditions are infections, sialolithiasis, tumors (benign and malignant) and autoimmune diseases.

Salivary Gland Diseases:

Salivary gland inflammations

They are called sialadenitis and may be due to viruses or microbes. The appearance of mumps in childhood caused by the mumps virus is typical. Microbial sialadenitis often occurs in submaxillar glands or parotids, and may be due to obstruction of pores that drain saliva from stenoses, inflammations or stones.

Sialolithiasis

Saliva contains salts that can, in some cases, form stones just like in the kidneys. Then the emissary of the gland is blocked, the drainage of the saliva stops, the gland swells and this is followed by inflammation with pain.

Sometimes sialolithiasis self-heals and sometimes requires the removal of the stone by a cut through the mouth. Endoscopy (sialendoscopy) is a useful diagnostic and therapeutic tool in the sialolithiasis of major salivary glands. In some cases it is necessary to remove the gland itself by surgery under general anesthesia.

Salivary Gland Tumors

These may be malignant or benign. Benign tumors are more common especially in the parotid area. The most common are the manifold gland and the Warthin tumor. Tumors usually grow slowly. But if not treated over the years, a benign tumor can be transformed into malignant.

Therefore, these tumors should always be treated with surgical abscission.

The most common surgical procedures performed for this reason are:

The appropriate surgery considering the parotid is partial or superficial parotidectomy. The surgery includes removal of part of the gland together with the tumor (en block).

It is done with an outer cut around the ear that extends towards the neck. It has the particularity of the presence of the facial nerve within the gland. Damage to the facial nerve leads to a disorder in the movement of the facial muscles.

The gland with the tumor is detached from the nerve branches and gets removed en block. In these procedures, we use a neuro-monitoring system, a system that checks the integrity of the nerve during surgery and warns us when, using our tools, we handle very close to the branches of the personal nerve.

The operation is executed with general anesthesia and usually requires hospitalization for two days. The aesthetic result is very satisfactory. In the submaxillar glands, an operation of choice is the abscission of the gland. This is done with a sub-maxillar cut and the aesthetic result is excellent.

Autoimmune Diseases

Sjogren’s syndrome is an autoimmune disease that causes dry mouth and dry eye due to salivary and lacrimal glands filtration. Sjogren’s syndrome is divided into the primary one when it appears on its own and in the secondary one when it is accompanied by other conditions.

Such diseases are rheumatoid arthritis, lupus erythematosus and scleroderma. Patients with secondary Sjogren syndrome need long-term follow-up due to the risk of developing a non-Hodgkin lymphoma that is 5-10%.