Salivary Gland Disorders

Diagram showing the major salivary glands (parotid, sub-mandibular & sub-lingual glands)

Salivary gland diseases are multiple and varied in cause. Salivary gland disorders include inflammatory, bacterial, viral and neoplastic causes.

Their presentation can be acute, recurrent or chronic.

The function of the salivary glands is to secrete saliva, which has a lubricating function, which protects the oral mucosa of the mouth during eating and speaking.

Saliva also contains digestive enzymes (e.g. salivary amylase) and has anti-microbial action and acts as a buffer.

Salivary gland dysfunction occurs when salivary rates are reduced and this can result in xerostomia (dry mouth).

The most common disorders of salivary glands involve mucous cysts, blockage by calcified stones, infection and abnormal growths. Various examples of disorders affecting the salivary glands are listed below.

Sialadenitis is inflammation of a salivary gland, usually caused by infections, although there are other less common causes of inflammation such as irradiation, allergic reactions or trauma.

Acute suppurative sialadenitis presents as rapid-onset pain and swelling and is treated with antibiotics, salivary massage, hydration and sialagogues (agents that increase the secretion of saliva) such as lemon drops or vitamin C lozenges.

Viral causes include Mumps and Human Immunodeficiency Virus and treatment is directed at the underlying disease.

Recurrent or chronic sialadenitis is more likely to be inflammatory than infectious; examples include recurrent parotitis of childhood and sialolithiasis (salivary stones).

Inflammation is commonly caused by an obstruction such as a stone or duct stricture. Management is directed at relieving the obstruction.

Benign and malignant tumours can occur in the salivary glands and usually present as a painless solitary neck mass. Diagnosis is made by imaging (e.g., ultra-sonography, computed tomography, magnetic resonance imaging) and biopsy (initially with fine-needle aspiration). Overall, most salivary gland tumours are benign and can be treated with surgical excision.