hey guys it's Ryan in this video we're gonna continue to talk about oral pathology and now we're gonna move to salivary gland diseases so we just finished talking about connective tissue tumors which are part of the submucosa and now we're going to stick with the submucosa but this time talk about diseases that impact salivary glands specifically for this first video we're going to talk about reactive legions so both major and minor salivary glands can be subject to numerous reactive influences including trauma infection metabolic changes and a minha logic dysfunction so sort of a miscellaneous category for this first video so mucus extravasated phenomenon is probably the most important one that you need to know it's a really long word but it kind of tells you what it's all about we're talking about mucus we're talking about that mucus being extravasated or leaking out into tissue and then that kind of informs what we're gonna be talking about right here so it's caused by trauma to the salivary duct so when a mucus seal is probably the most the most prominent most common form of mucus extravasated phenomena mucus seal just means as containing mucus and it's most common on the lower lip so this is a picture of a very classic mucus seal so where this bluish translucent appearance super common and it would basically be if you bit your lip a little too hard you could have punctured and caused trauma to a salivary duct and then you get blockage and it forms this collection of mucus fluid in this layer of tissue so mucus seal very common and when it occurs on the floor of the mouth it's no longer called a mucus seal that's called a Randall ax which means frogs belly I think it's because it has this kind of larger appearance when it occurs at the floor of the mouth so mucus eel granula both appease our mucus extravasated phenomena and a treatment would be complete excision complete is important because you have to remove the entire affected gland and this is just a minor salivary gland or else you have a higher chance of recurrence if you don't take care of the entire thing so you have to remove the entire accessory salivary gland next we have mucous retention cysts and before I dive into this one I want to clarify that some people use these two terms interchangeably they use mucous extravasated phenomenon and mucous retention cysts as meaning the same thing so this can refer to mucous seals and Randy 'la it depends on the person asking the question I think in terms of a Board Exam standpoint will treat them as kind of similar but slightly distinct and the difference for this purpose is that histologically mucous retention cysts is a true cyst and assist by definition is lined by epithelium so whereas the mucous extravasated phenomenon doesn't necessarily have to be surrounded by epithelium this one does and this one is specifically caused by blockage of a salivary duct by a sigh a low lift which is a calcified calcified mass that's blocking a salivary duct so it's caused by blockage rather than trauma which is causing the phenomenon that we talked about blockage you're retaining fluid it's a retention cyst so again a little bit confusing some people use these two interchangeably but we'll treat them slightly different in this cyst distinction and now to add on another layer these are distinct from and not to be confused with sinus lesions that have very similar names there's something called a sinus mucus seal and there's a natural pseudocyst also called a sinus retention cyst so if you see the word sign in there or antral which is referring to the maxillary sinus those are separate lesions that we're gonna talk about very soon so next we have necrotizing sie alle metaplasia this I feel like comes up a lot and practice questions as well the most important thing to remember is that it's rapidly expanding and an ulcerative lesion so you here you can see this ulcerative appearance and usually it's due to ischemic necrosis of minor salivary glands in response to trauma or local anesthesia for example you're giving a greater Palatine block now this is something that heals on its own and six to ten weeks and doesn't need any other treatment other than palliative treating the symptoms okay so now we have sinus or attention cyst so to separate that from mucous retention cysts the sinus is only talking about blockage of glands in the sinus mucosa and here we can't see it clinically but we can see it radiographically so we can see this sort of radiopaque dome-shaped lesion along the base the floor of the sinus here so that's a sinus retention cyst and no treatment is typically needed for this it's pretty benign now the sinus mucous seal is in some ways similar to this one and that involves either a trauma or blockage of the ostium which is the opening that drains the maxillary sinus into the nasal cavity however a sinus mucus seal tends to expand gradually and be more aggressive than this sinus retention cyst next we have sarcoidosis which is hyper immune and this means it involves granulomas hyper immune meaning that the immune system is responding it's over responding to some stimulus something we talked about when we talked about mucosal lesions that were meena logic sarcoidosis may be triggered by mycobacteria which is also the EDL etiologic agent for tuberculosis primarily it's a pulmonary disease but it also affects the salivary glands which is why we're talking about it in this video and mucosa since it's affecting the salivary glands it results in xerus tomia which is probably the most important component of sarcoidosis xerostomia being dry mouth which is often a thing tested on exams because dry mouth has very serious side effects for the oral health in terms of yet having a higher caries risk now again I love having these syndromes mapped out as mathematical equations so we actually have two syndromes this time linking to sarcoidosis so Lofgren syndrome involves erythema nodosum bilateral hilar lymph adenopathy and the hilar lymph nodes are those associated with the lungs and arthritis whereas here Fort syndrome involves anterior uveitis parotid gland enlargement facial nerve palsy and a fever it's also called UVO parotid fever which is probably the best way to remember this one because it sort of merges together most of the components of the syndrome it merges together this uveitis and merges together the parotid gland involvement and the fever and you just have to remember the facial nerve palsy on top of all that so here for you vo parotid fever and Lofgren involving the lymph nodes L&L maybe can help there and this redness and arthritis since it's hyper immune we're using corticosteroids which are an anti-inflammatory that can calm down the overactive immune system and now we have shows Sjogren's syndrome excuse me and Sjogren's syndrome is probably one of the most just tested autoimmune conditions for dental exams because it affects the salivary glands very much so so Sjogren's is autoimmune and so lymphocyte mediated it affects the salivary and the tear gland so it just kind of drives out the entire body and it has two main forms the primary Sjogren's syndrome involves this corrado junk - conjunctivitis sicka which is just a fancy word for dry eyes and xerostomia which we've already said is dry mouth now secondary involves both dry eyes and dry mouth that's the same plus another autoimmune disease usually rheumatoid arthritis or RA rheumatory rheumatoid arthritis is another autoimmune condition which often occurs in tandem with an autoimmune condition like Sjogren's and RA can involve the TMJ so that itself can have some oral and facial components treatment for this is symptomatic and any patient that has Sjogren's syndrome is going to have a high caries risk due to 0.so Mia so that's it for this video thanks for watching guys I hope you found it helpful if you did please leave a like on this video and subscribe to my channel for more oral pathology and other things dentistry thanks again for watching and I'll see you all in the next video