This document discusses disorders of the salivary glands. It begins by describing the location and functions of the major salivary glands. Common disorders include parotitis, sialadenitis, salivary calculi, and neoplasms. Parotitis is typically caused by viral infection and presents with fever, swelling, and pain. Sialadenitis can result from dehydration, radiation, or infection and causes pain, swelling, and discharge. Salivary calculi form in ducts and cause colicky pain. While most salivary neoplasms are benign, radiation exposure and older age increase cancer risks. Diagnosis involves imaging and biopsy. Treatment depends on the disorder but may include antibiotics

1. DISORDERS OF THE SALIVARY GLANDS
SUBMITTED BY :
V.RAMYA,
TUTOR,
SRMTCON.

2. SALIVARY GLANDS

3. INTRODUCTION
• The salivary glands consist of ; the parotid glands ,one on
each side of the face below the ear ; the submandibular
glands, located below the jaw bone ; the sublingual glands ,in
the floor of the mouth under the tongue ; and the minor salivary
glands in the lips ,buccal mucosa .
• And the linning the of the mouth, and throat.

4. INTRODUCTION
•About 1500 ML of saliva is produced daily and
swallowed .
•The major functions of the salivary glands
include lubrication ,protection against harmful
bacteria ,and digestion.

5. PAROTITIS
• Parotitis ( Inflammation of the parotid gland) is the most
common inflammatory condition of the salivary glands.
• Inflammation of the parotid ,may be due to mumps (epidemic
parotitis) , a communicable disease caused by viral infection
and most commonly affecting unvaccinated children.

6. PAROTITIS

7. CAUSATIVE ORGANISM
• People who are older, acutely ill, or debilitated with decreased
salivary flow from general dehydration or medications are at
high risk of bacterial parotitis.
• The infective organism typically staphylococcus aureus ,
• Travels from the mouth through the salivary duct.

8. SIGNS AND SYMPTOMS
• The onset of parotitis is sudden and associated with
• Fever,
• Chills,
• And other systemic signs of infection.
• The gland swells and becomes tense and tender.

9. SIGNS AND SYMPTOMS
•The patient feels pain in the ear ;
•and swollen glands interfere with swallowing .
•The swelling increases rapidly,
•and the overlying skin soon becomes red and
shiny.

10. MEDICAL MANAGEMENT
• Medical management include maintaining adequate
nutrition and fluid intake
• Good oral hygiene and
• Discontinuing medications ( tranquilizers ,diuretic
agents) that can diminish salivation.
• Antibiotic therapy is necessary for bacterial parotitis,
and analgesics may be prescribed to control pain.

11. SURGICAL MANAGEMENT
• If antibiotic therapy is not effective ,the gland may
need to be drained by a surgical procedure known as
parotidectomy.
•This procedure may be necessary to treat chronic
parotitis.
•The patient is advised to have any necessary dental
work performed prior to surgery.

12. SIALADENITIS

13. SIALADENITIS
•Sialadenitis (
inflammation of the
salivary glands)

14. CAUSES
•Sialadenitis caused by dehydration,
•Radiation therapy,
•stress,
•malnutrition,
•salivary gland calculi ( stones; sialolithiasis),
•Or improper oral hygiene.

15. CAUSATIVE ORGANISM
• The infection is commonly associated with infection by
staphylococcus aureus .
• In hospitalized or institutionalized patients, the infecting
organism may be methicillin – resistant
• Staphyloccus aureus (MRSA)

16. SIGNS AND SYMPTOMS
•Pain
•Swelling
•And purulent discharge

17. MEDICAL MANAGEMENT
•Antibiotics are used to treat infections.
•Massage, hydration, warm compresses, and
sialogogues ( substance that trigger saliva flow
like hard candy or lemon juice )
•Frequently cure the problem.

18. SURGICAL MANAGEMENT
•Chronic sialadenitis is typically due to decreased
salivary flow .
•Surgical drainage or excision of the gland and its duct
are considered in case of sialadenitis that are recurrent
or refractory antibiotics .

19. SALIVARY CALCULUS

20. SALIVARY CALCULUS
• Sialolithiasis or salivary calculi (stones) ,usually occur in (
80% to 90% of cases ) in the submandibular gland .
• Salivary calculi are formed mainly from calcium phosphate.
• If located within the gland ,the calculi are irregular and vary
in diameter from 1 to 35 mm

21. SIGNS AND SYMPTOMS
•Calculi within the salivary gland itself may cause no
symptoms unless infection arises ;
•However ,a calculus that obstructs the glands duct
causes swelling and sudden ,local, and often colicky
pain, which is abruptly relieved by a gush of saliva.

22. DIAGNOSTIC EVALUATION
•This characteristics symptom is often disclosed in the
patients health history.
•On physical assessment ,the gland is swollen and
quite tender, the stone itself can be palpable ,and its
shadow may be seen on x- ray images .

23. DIAGNOSTIC EVALUATION
•Salivary gland ultrasonography or sialography (x- ray
studies imaged after the injection of radiopaque
substance in to the duct).
•May be required to demonstrate obstruction of the
duct.

24. SURGICAL MANAGEMENT
• The calculus can be extracted fairly easily from the duct in
the mouth.
• Sometimes, enlargement of the ductal orifice permits the
stone to pass spontaneously.
• Occasionally , lithotripsy, a procedure that uses shock waves
to disintegrate the stone ,may be used instead of surgical
extraction for parotid stones and smaller submandibular
stones.

25. SURGICAL MANAGEMENT
•Lithotripsy requires NO anesthesia , sedation, or
analgesia.
•Surgery may necessary to do remove the gland
if symoptoms and calculi recur repeatedly.

26. LITHOTRIPSY PROCEDURE

27. NEOPLASMS
• Although they are uncommon ,neoplasms (tumors or
growths) of almost any type may develop in the salivary
gland ;
• 50% of these are benign, with 70% to 80% of all salivary
neoplasms beginning in the parotid gland.
• Neoplasm accounts for more neck cancers ( national cancer
institute {NCI}

28. RISK FACTORS
•Prior exposure to radiation to the head and neck,
•Older age ,
•And specific carcinogens introduce in specific work.
•Environments ( asbestos, plumbing,and
woodworking),

29. SIGNS AND SYMPTOMS
• Most patients with a benign tumor present with a painless
swelling of the glands;
• Patients with a malignancy tend to have neurologic
symptoms
• Weakness or numbness
• Facial pain

30. DIAGNOSTIC EVALUATION
•Diagnosis is based on the
•Health history
•Physical examination,
•And the result of fine –needle aspiration biopsy.

31. SURGICAL MANAGEMENT
•Early – stage salivary gland tumors are usually
curable with surgery alone.
•Dissection is carefully performed to preserve the
seventh cranial nerve (facial nerve ), although it may
not be possible to do so if the tumor is extensive.

32. COMPLICATIONS
•Complications from surgery may
involve facial nerve dysfunction
,and frey syndrome.

33. FREY SYNDROME.

34. FREY SYNDROME.
•Frey syndrome ,also known as auriculotemporal
syndrome, involves facial sweating and flushing
in the general location of the parotid gland that
occurs while eating.

35. FREY SYNDROME TREATMENT
• Frey syndrome may be successfully treated with botulinum toxin type
a injections.
• If the salivary gland tumor is malignant ,radiation therapy may follow
surgery.
• Radiation therapy alone may be a treatment choice for tumors
thought to be localized or if there is risk of facial nerve damage from
surgical intervention.

36. CHEMOTHERAPY
•Chemotherapy may be considered in late
stages.
•Recurrent tumors usually are more
aggressive than initial tumors.

37. BIBLIOGRAPHY
• Brunner and Suddarth’s textbook of Medical – Surgical Nursing ,South Asian edition –
• Volume 1, Published by Wolters Kluwer. Page reffered to 845 to 846.
• Ansari and Kaur Medical Surgical Nursing ,Published by Pee Vee ,2011 edition .page referred
• to 446 to 449.
• https://www.slideshare.net/drsaleh80/salivary-gland-disorders-121185024
• https://www.slideshare.net/UDDent/salivary-glands-diseases
• https://www.slideshare.net/DrKrishnaKoirala/22-diseases-of-salivary-glands

38. THANK YOU