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Salivary Gland Diseases Overview

Apr 27, 2025

Oral Pathology: Salivary Gland Diseases

Overview

  • Focus on salivary gland diseases, following a discussion on connective tissue tumors.
  • Both major and minor salivary glands can be impacted by:
    • Trauma
    • Infection
    • Metabolic changes
    • Immunologic dysfunction

Reactive Lesions

Mucus Extravasation Phenomenon

  • Definition: Leakage of mucus into tissue due to trauma to salivary duct.
  • Common Form: Mucus seal (mucocele), typically on lower lip.
    • Appears bluish and translucent.
    • Caused by biting the lip too hard, puncturing the salivary duct.
  • Ranula: Mucus seal on the floor of the mouth, larger in appearance.
  • Treatment: Complete excision of the affected gland to prevent recurrence.

Mucous Retention Cysts

  • Often confused with mucus extravasation phenomena but are distinct.
  • Histology: True cysts lined by epithelium.
  • Cause: Blockage of salivary duct by a sialolith (calcified mass).
  • Note: Different from sinus lesions with similar names (e.g., sinus mucocele).

Necrotizing Sialometaplasia

  • Characteristics: Rapidly expanding ulcerative lesion.
  • Cause: Ischemic necrosis of minor salivary glands due to trauma or local anesthesia.
  • Healing: Self-healing within 6-10 weeks, requires only palliative care.

Sinus Retention Cyst vs. Sinus Mucocele

Sinus Retention Cyst

  • Location: Blockage of glands in sinus mucosa.
  • Detection: Visible radiographically as radiopaque dome-shaped lesions.
  • Treatment: Typically none required.

Sinus Mucocele

  • Cause: Trauma or blockage of the ostium.
  • Characteristics: Gradual expansion, more aggressive than sinus retention cyst.

Sarcoidosis

  • Type: Hyperimmune granulomatous condition.
  • Possible Cause: Triggered by mycobacteria, agent for tuberculosis.
  • Primary Effect: Pulmonary, but affects salivary glands causing xerostomia (dry mouth).
  • Symptoms:
    • Lofgren Syndrome: Erythema nodosum, bilateral hilar lymphadenopathy, arthritis.
    • Heerfordt Syndrome: Anterior uveitis, parotid gland enlargement, facial nerve palsy, fever.
  • Treatment: Corticosteroids for anti-inflammatory effect.

Sjogren's Syndrome

  • Type: Autoimmune disease, lymphocyte-mediated.
  • Effects: Affects salivary and tear glands, causing dry eyes and dry mouth.
  • Forms:
    • Primary: Dry eyes (keratoconjunctivitis sicca) and xerostomia.
    • Secondary: Same as primary plus another autoimmune disease (e.g., rheumatoid arthritis, which may involve TMJ).
  • Treatment: Symptomatic management; high caries risk due to xerostomia.

Note: This summary provides a high-level overview of salivary gland diseases discussed in the lecture, focusing on reactive lesions, cysts, and autoimmune conditions.

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