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Salivary Gland Neoplasms
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Salivary Gland Neoplasms

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  • 1. SALIVARY GLANDS
  • 2. Parotid gland Surgical anatomy
  • 3.
    • Serous gland
    • Irregular shape
    • Fills the gap
  • 4.
    • Upper& lower poles
    • Lateral, anterior & deep surfaces
  • 5.
    • Surrounded by parotid sheath
    • Derived from cervical fascia
    • Very tough capsule
  • 6.
    • Upper pole concave
    • Adheres to ext acoustic meatus
    • Lower pole rounded
  • 7. Ant surface
    • U shaped
    • Clasping the ramus of mandible
    • Masseter & medial pterygoid
    • Stylomandibular ligament
  • 8. Anterior border
    • Parotid duct
    • Branches of facial nerve
    • Terminal branches of ECA
  • 9. Deep surface
    • Mastoid with the muscles
    • Styloid with the muscles, two ligaments
    • Styloid seperates it from ICA &IJV
  • 10. Lateral surface
    • Subcutaneous
    • flat
  • 11.
    • Facial nerve
    • Retromandibular vein
    • ECA
  • 12. Parotid duct
    • 5cm long
    • Across masseter
    • Pierces buccinator
  • 13. Nerve supply
    • Otic ganglion- secretomotor fibres
    • Inferior salivatory nucleus - 9 th N – tympanic branch – tympanic plexus – lesser petrosal N – otic ganglion
  • 14.
    • Sympathetics - superior cervical ganglion
    • Sensory fibres auriculotemporal N
    • Parotid fascia great auricular N
  • 15. Submandibular gland Surgical anatomy
  • 16.
    • Mixed gland
    • Large superficial part
    • Small deep part
  • 17. Superficial lobe
    • Fills space b/n mandible , mylohyoid &cervical fascia
    • Three surfaces
  • 18. Lateral surface
    • SM fossa of mandible
    • Medial pterygoid insertion
    • Facial artery
  • 19. Superficial surface
    • Covered by skin , platysma , deep fascia
    • Crossed by facial vein & cervical br of facial N
    • SM lymph nodes lie outside & within the gland
  • 20. Medial surface
    • lies against the mylohyoid and its NV bundle
    • Hyoglossus, lingual N , SM ganglion , hypoglossal N
  • 21. Deep part
    • b/n mylohyoid & hyoglossus
    • Lingual N above
    • Hypoglossal SM duct below
  • 22. Submandibular duct
    • 5cm long
    • Emerges from superficial part
    • b/n mylohyoid & hyoglossus
    • Then b/n SL gland & geniohyoid
  • 23. Nerve supply
    • Secretomotor SM ganglion
    • Sup salivary N - nervus intermedius - chorda tympani - lingual N
  • 24. Sublingual gland
    • Almond shaped
    • In front of ant border of hyoglossus
    • b/n mylohyoid & genioglossus
    • Mucous gland
  • 25. Diseases of salivary glands benign
  • 26. Sialolithiasis
    • Most commonly occurs in c/c sialadenitis
    • 80% of stones occur in whartons duct
  • 27. Reasons
    • More alkaline
    • More viscous
    • Higher concentration of Ca & PO4
    • Angulation of duct & vertical orientation
  • 28. Diagnosis
    • History & clinical examination
    • X – ray
    • sialography
  • 29. Treatment
    • Mannual pushing of stones to the opening
    • Surgical incision over the stone & removal
  • 30. Parotitis
    • Mumps MC cause of non suppurative parotitis
    • Bilateral
    • Paramyxo virus
  • 31.
    • 1-2 days prodromal period – fever ,chills , head ache
    • Followed by pain & swelling of parotid glands
    • Very severe pain aggravated by eating & drinking
  • 32.
    • Resolve spontaneously in 5 – 10 days
    • Life long immunity
  • 33. Bacterial parotitis
    • Acute – parotid
    • Ascending infection
    • Dehydration , cachexia , obstruction
  • 34. Presentation
    • Tender,red, painful parotid swelling
    • Malaise, pyrexia
    • Lower part more involved
    • Staph & strep
  • 35. Treatment
    • Conservative
    • Drainage – in case of abscess
  • 36. c/c sial adenitis
    • Sub mandibular gland
    • Poor recovery
    • Intial conservative treatment
    • Sial adenectomy
  • 37. Parotitis
    • HIV – SGD
    • Lymphoproliferative & cystic enlargement
    • Virus in saliva
    • surgery
  • 38. Granulomatous
    • TB
    • Non TB mycobacteria
    • Actinomycosis
    • Cat scratch disease
  • 39. Salivary fistula
    • Common in parotid
    • Congenital/acquired
    • Surgery, trauma , sepsis
  • 40.
    • Salivary gland fistula – saliva collects S/c
    • Aspiration
    • Pressure bandage
  • 41. Salivary duct fistula
    • Intra oral - no treatment
    • Cutaneous