Salivary gland disorders
The most relevant are the largest as they contribute most of the saliva and most of the most common pathologies fall on them. The major salivary glands are the parotid, submaxillary, and sublingual glands.
Disorders of the secretion of the salivary glands
Depending on the amount secreted, we can call these alterations:
- Asialia, total suppression of saliva secretion. It is rare. It occurs due to the congenital absence of the salivary glands or due to their atrophy.
- Hyposialia, a condition characterized by a daily saliva secretion of less than 500ml. Saliva is more viscous than normal. This situation causes the so-called dry mouth or xerostomia. Xerostomia favors caries and sialadenitis (inflammation of the salivary glands) as well as oral septic or infectious processes. It can be caused by the following causes:
Taking barbiturate, cycloplegic, antihypertensive or tricyclic antidepressant drugs.
Febrile processes and / or dehydration.
- Degenerative diseases of the salivary glands, Sjögren's disease ...
- Partial agenesis of the salivary glands
- Atrophy of the salivary glands after treatments such as radiotherapy, cytostatics or radioactive iodine.
- Sialorrhea is the pathological increase in salivary secretion. It is caused, on a large number of occasions, by irritating stimulation of the oral mucosa.
Oropharyngeal inflammatory processes.
- Neurogenic sialadenosis such as trigeminal neuralgia or Frey's syndrome.
- Lesions of the central nervous system, salivatory nuclei, basal ganglia, cortex or Parkinson's.
- Digestive system disorders such as esophagitis, gastritis, ulcus or pancreatitis.
Obstructive disorders
- Ranula, bluish soft mass on the floor of the mouth that occurs due to trauma to the sublingual gland with rupture of the salivary duct causing the leakage and accumulation of mucin (a component of saliva).
- Mucocele, trauma caused by the involuntary or nervous bite of the lower lip giving rise to a cyst with salivary content.
- Sialolithiasis, formation of a stone in the salivary glands causing obstruction in the duct of excretion. It is very frequent, constituting 30% of all salivary pathologies. It affects the submaxillary gland in 80% of cases. A painful mass appears coinciding with meals due to the stimulation of saliva production.
Inflammatory Disorders
Sialadenitis: it is the most frequent cause of obstruction of the salivary glands. It may be acute or chronic:
- Acute: it is temporary and, for the most part, caused by infectious agents, among them it is worth highlighting:
- Bacterial that most often affects the parotid gland. The germ comes from the mouth and infects the gland inducing a sudden and painful one-sided inflammation. It can cause a sign called trimus (difficulty opening the mouth). If left untreated, the infection can degenerate into an abscess (or purulent collection).
- Viral: they are usually bilateral in 75% of cases. They are frequent in children, and can occur without fever in 30% of cases. It manifests itself with inflammation of the gland. Normally the target gland is the parotid (or Parotitis, commonly known as Mumps). The most common responsible virus is paramyxovirus and others such as coxackie and cytomegalovirus.
- Chronic: is one that persists over time due to complications of acute infectious sialadenitis or autoimmune pathologies, among other diseases.
Chronic parotitis in adults: recurrent inflammation due to obstruction of the duct of the affected gland. It presents with cloudy saliva and recurrent painful swelling. In childhood, it is secondary to epidemic parotitis or congenital ectasias (tamponade).
Other
- Chronic sclerosing sialodenitis of the submaxillary gland: caused by obstructive sialodenosis and an associated abnormal immune reaction.
- Sjögren's syndrome: autoimmune pathology that destroys the glands.
- Hethford syndrome or parotid sarcoidosis.
- Sialodenosis caused by metabolic diseases such as diabetes.
- Frey's syndrome or aberrant degeneration of parasympathetic fibers.
- Salivary gland tumors
They are rare, representing 0.5-1% of tumors in the body.
80% of tumors are benign. Both benign and malignant tumors nest, for the most part, in the parotid gland.
In adults, the most common benign tumor is the pleomorphic or mixed adenoma. It generally affects young people between the ages of 30 and 40.
The second most common is Warthin's tumor or cystadenolymphoma.
The most common malignant tumor in adults is mucoepidermoid carcinoma.
In children, hemangioma and mucoepidermoid carcinoma are the most common benign and malignant tumors, respectively.
(Updated at Apr 13 / 2024)