Skip to Main Content

+

  • • Paired major salivary glands include parotid, submandibular, and sublingual glands

    • Minor salivary glands are distributed in the mucosa of the lips, cheeks, hard and soft palate, uvula, floor of mouth, tongue, and peritonsillar region

    • Few salivary glands in the nasopharynx, paranasal sinuses, larynx, trachea, bronchi, and lacrimal glands

    • Infectious and inflammatory diseases of the salivary glands are common, and frequently involve the major salivary glands, especially the parotids

    • Tend to occur in those patients whose overall health is compromised (by poor nutrition, dehydration, altered fluid and electrolyte balance, or immunocompromise)

    • Etiologies include:

    • -Actinomycosis

      -Acute bacterial sialoadenitis

      -Cat scratch disease

      -Mumps

      -TB

++

Epidemiology

+

  • S aureus is the most common bacteria in acute bacterial sialoadenitis

    • Mumps is the most common viral etiology of sialoadenitis; other etiologies include coxsackievirus A and echovirus

    • Mumps primarily affects children and young adults

    • Fungal sialoadenitis (usually with actinomycosis) usually follows dental manipulations

++

Symptoms and Signs

+

  • • Parapharyngeal edema

    • Pain

    • Fever

    • Indurated, enlarged, tender gland

    • External pressure on the gland release purulent material from gland opening

    • Fluctuance

    • Bilateral swelling and clear salivary secretions suggest viral etiology

    • Trismus

++

Laboratory Findings

+

  • • Leukocytosis

++

Imaging Findings

+

  • • X-ray for sialolith

    • CT scan if suspect abscess

    • Sialogram

    • Radionuclide scanning

+

  • • Abscess and fluctuance easily palpated in submandibular glands; septations in parotid gland lead to formation of multiple, small, nonpalpable abscesses

++

Rule Out

+

  • • Salivary gland tumor

+

  • • History and physical exam

    • Cultures of salivary secretions; possibly blood cultures (depending on degree of systemic illness)

+

  • • Antibiotic therapy and fluid management is the mainstay of treatment of acute bacterial sialoadenitis

    • No specific treatment for viral sialoadenitis

++

Surgery

++

Indications

+

  • • Lack of clinical improvement with antibiotics alone; aim of surgical intervention is abscess drainage

    • Gland excision for chronic/recurrent sialoadenitis or sialolithiasis

++

Medications

+

  • • Antibiotics, antifungals, antituberculous chemotherapy

++

Complications

+

  • • Chronic sialoadentis

    • Altered salivary flow

    • Sialolithiasis

    • Tooth damage due to reduced salivary flow

++

References

Baldwin AJ, Foster ME. Tuberculous parotitis. Br J Oral Maxillofacial Surg. 2002;40:444.  [PubMed: 12379196]
Brook I. Acute bacterial suppurative parotitis: microbiology and management. J Craniofacial Surg. 2003;14:37.  [PubMed: 12544218]
Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002;65:93.  [PubMed: 11804446]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.