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Sialoadenosis (sialosis) -maxillofacial pathology
- 3. Sialosis (sialadenosis) is a chronic, bilateral, diffuse, non- inflammatory, non-neoplastic swelling of the major salivary glands that primarily affects the parotid glands, but occasionally involves the submandibular glands and rarely, the minor salivary glands.This can be painless or in some instances tender. www.dental-lifestyle.com
- 4. The typical clinical symptom is a bilateral, often recurrent,symmetrical and painless (it is often painless but not invariably so)swelling of the parotid gland. The characteristic pathological findings consist in an acinar cell hypertrophy without any inflammatory signs. According to this definition, sialadenosis has to be separated from those diseases of salivary glands, which are primarily altered by inflammation of the salivary tissue with secondary secretory disturbances. Patients are aged 30 - 69 years at onset and the sexes are equally involved. www.dental-lifestyle.com
- 5. CAUSES: Sialosis may be idiopathic or may be associated with the following: www.dental-lifestyle.com
- 6. DRUGS Among the wide range of drugs that may induce sialosis, anti-hypertensiv agents are prominent. 1.Alcohol abuse ± liver cirrhosis + hepatic steatosis and alcoholic hepatitis. 2.Sympathomimetics such as isoprenaline 3.Phenylbutazone 4.Anti-thyroids & phenothiazines www.dental-lifestyle.com
- 7. ENDOCRINE: 1.Diabetes Mellitus (reported prevalence of sialosis in diabetes ranging from 10% to 80%) 2.Pregnancy 3.Acromegaly 4.Following oophorectomy www.dental-lifestyle.com
- 8. NUTRITIONAL DISORDERS: Any disorder that affects the digestion of food or its absorption over a prolonged period, can result in sialosis. 1.Malnutrition -pellagra or kwashiorkor 2.Cystic Fibrosis & pancreatitis 3.Anorexia Nervosa 4.Bulimia 5.Vitamin A defficiency 6.GIT diseases www.dental-lifestyle.com
- 9. Several causes have been recorded, most of which are associated with (mal-)nutrition, metabolism or drugs and have a unifying feature in autonomic neuropathy. Changes in salivary aquaporin water channels may also be involved. www.dental-lifestyle.com
- 11. The diagnosis for sialosis must exclude inflammatory causes of salivary swelling particularly Sjogren syndrome,HIV infection,sarcoidosis and lymphoepithelial disease by relevant investigations. www.dental-lifestyle.com
- 12. 1.Physically,the groove between the mastoid process and the ramus of the mandible becomes annihilated and the swelling that is formed gives a trapezoid appearance. 2.Sialography is rarely used but can be useful in diagnosis. A leafless winter tree may be seen in the result.Helps differentiate space occupying lesions. www.dental-lifestyle.com
- 13. 3.CT imaging can be used to diagnose sialadenosis but no specific features can be seen. 4.MRI is one the best methods for diagnosing a salivary gland condition and it also helps to exclude other pathologies. www.dental-lifestyle.com
- 14. 5.Fine needle aspiration or open biopsy examinations may help with the diagnosis but they are rarely indicated. 6.Salivary sonography can help us exclude other salivary gland pathologies like MRI. 7.Sialochemistry has no benefit in diagnosis,although raised concetrations of potassium,calcium and amylase activity have been reported. www.dental-lifestyle.com
- 15. 8.Sialometry is also of little practical value because in this case salivary secretory activity is usually within normal limits. 9.Blood tests ,we can notice increased glucose levels. www.dental-lifestyle.com
- 17. No treatment is necessary. Sialosis may resolve if the causative agents will be treated appropriately (diabetes mellitus ,alcoholism,drugs etc.). If the glands are disfiguring, superficial parotidectomy to improve the appearance could be considered. www.dental-lifestyle.com