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Necrotizing sialometaplasia

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  • 1. NECROTIZING SIALOMETAPLASIA
  • 2. Necrotizing Sialometaplasia • Uncommon locally destructive inflammatory condition of the salivary glands. • Cause: unknown but they believe it is the result of ischemia of the salivary tissue that leads to local infaction.
  • 3. ISCHEMIA AND LOCAL INFARCTION LEADING TO NECROTIZING SIALOMETAPLASIA OXYGEN No blood supply No oxygen No ATP No glucose
  • 4. Predisposing factors: –Traumatic injuries –Dental injections –Ill fitting dentures –Upper respiratory infections –Adjacent tumors –Previous tumors ***However many cases occur without any known predisposing factors.
  • 5. CLINICAL FEATURES • Most frequently develops in the palatal salivary glands • Hard palate > soft palate ***2/3 of palatal cases are unilateral, with the rest being bilateral or midline in location
  • 6. Unilateral
  • 7. Bilateral Midline in location
  • 8. CLINICAL FEATURES • Has also been reported in other minor salivary gland sites and occasionally in the parotid gland. • Submandibular and sublingual glands are rarely affected.
  • 9. CLINICAL FEATURES • Most common in adults and in men • The condition appears initially as a non-ulcerated swelling often associated with pain or paresthesia with crater-like ulcer that can range from less than 1cm to more than 5cm in diameter appearing within 2 to 3 weeks.
  • 10. CLINICAL FEATURES
  • 11. HISTOPATHOLOGIC FEATURES • Microscopic appearance of necrotizing sialometaplasia is characterized by acinar necrosis in early lesions, followed by associated squamous metaplasia of the salivary ducts.
  • 12. HISTOPATHOLOGIC FEATURES
  • 13. Treatment • The lesion is self-limiting in most instances and heals uneventfully.
  • 14. Xerostomia
  • 15. Xerostomia • Refers to subjective sensation of a “dry mouth” • Frequently but not always associated with salivary gland hypofunction.
  • 16. Xerostomia
  • 17. CAUSES • DEVELOPMENTAL -Salivary gland aplasia • WATER OR METABOLITE LOSS impaired fluid intake -impaired fluid intake -hemorrhage -vomiting or diarrhea
  • 18. CAUSES • IATROGENIC -medications • LOCAL FACTORS -decreased mastication -smoking -mouth breathing
  • 19. CAUSES • SYSTEMIC DISEASES -Sjogren’s syndrome -diabetes mellitus -diabetes insipidus -sarcoiadosis -HIV infection -Graft-versus-host disease -psychogenic disorder