This PowerPoint will describe the anatomy and physiology of the salivary gland in an easier way.

1. Anatomy and Physiology of
Salivary Glands
Dr. S. Prem Davis
Department of ENT
SVMCH & RC
Puducherry

2. Contents
• Glands
• Types of Glands
• Embryology and Morphology of Salivary Glands
• Parotid Gland
• Submandibular Gland
• Sublingual Gland
• Minor Salivary Glands
• Physiology of Salivary Secretions

3. Introduction - Glands
• A cell, group of cells, or organ that selectively removes materials
from the blood, concentrates or alters them, and secretes them for
further use in the body or for elimination from the body
• Typically, a gland consists of either cuboidal or columnar epithelium
resting on a basement membrane and is surrounded by a plexus, or
meshwork, of blood vessels.

4. Types of Glands:
• Endocrine, or ductless, glands (e.g., pituitary, thyroid, adrenal)
secrete substances known as hormones
• Exocrine glands (e.g., salivary, sweat, digestive) discharge their
products through ducts.

5. Types of Exocrine glands

6. Types based on Ductal Pattern - Exocrine

7. Salivary Glands
• Salivary glands are a group of exocrine, merocrine, simple/compound
tubulo-acinar type of glands secreting saliva
• The saliva forms a film of fluid coating the teeth and mucosa thereby
creating and regulating a healthy environment in the oral cavity
• Oral fluid –
• Saliva, includes the secretion of major & minor glands,
• Desquamated oral epithelial cells,
• Microorganisms and their products,
• Food debris and Serum components and inflammatory cells

8. Classifying Salivary Glands
• Based on size
• Histochemical nature of fluid
• Ductal system

9. Classifying Salivary Glands
• According to size :
• Major salivary glands : Parotid, Submandibular , Sublingual
• Minor salivary glands :
• Buccal / Labial
• Palatine
• Tonsillar ( WEBER’S GLAND)
• Molar or Retromolar Glands (CARMALT’S GLAND)
• Anterior Lingual Gland (BLANDIN – NUHN)
• Posterior lingual Gland (VON-EBNER)

10. According to nature of secretion:
• Pure Serous – Parotid, Glands of Von Ebner
• Pure Mucous – Anterior lingual Glands of Blandin and Nuhn, Weber
Gland
• Mixed – Submandibular and Sublingual

11. According to ductal systems
• Simple – Minor Salivary glands
• Compound – Major Salivary glands

12. Embryology
• All major salivary glands- ectoderm
• Some minor- ectoderm and endoderm
• Parotid gland(6th wk)----submandibular(6th wk)----sublingual(8th wk)
• Parotid - first to develop but - last become to encapsulated, after the
lymphatics develop.
• Results in entrapment of the lymphatics deep to the capsule in the
parenchyma of the gland.
Applied anatomy
• Salivary epithelial cells - included within these lymph nodes and
this may be important in the development of Warthin’s tumors and
Lymphoepithelial cysts within the parotid gland.

13. Microscopic anatomy
• Salivary glands are made up of
secretory acini and ducts.
Three types of acinus
• Serous (protein-secreting) – spherical
cells rich in zymogen granules
• Mucous (mucin-secreting) – tubular
shaped cells; mucin granules(larger
granules producing mucoproteins)
• Mixed – varying proportions of serous
and mucous acinar cells.

14. • Within the acinus, the acinar cells and the cells of the
proximal ductal system (intercalated duct) are
enveloped by pseudopodia of surrounding
myoepithelial cells.
• Contractile properties and create the peristalsis action
which moves saliva away from the acinus, distally along
the salivary duct system.
• The lumen of the acinus communicates directly
with the lumen of the duct.
• The ductal system, from proximal to distal, comprises
the intercalated duct, striated duct and excretory duct.

15. Applied Anatomy - Theories
• Basal Reserve Cell Theory
• Basal cells of both excretory and intercalated ducts responsible for
differentiation of functional units.
• Pluripotent Unicellular Reserve Cell Theory
• Basal cells of excretory duct responsible for development of all remaining
salivary gland Tumor.
• Semi pluripotent Bicellular Reserve Cell Theory
• The outer (Basal) layer of cells give rise to inner luminal layer
• 2 cells – Excretory duct reserve cells
Intercalated duct reserve cells

16. Applied Anatomy
• From Excretory Duct
• Mucoepidermoid carcinoma
• Primary SCC
• Salivary Duct Carcinoma
• From Intercalated Duct
• Pleomorphic and monomorphic Adenoma
• Polymorphous low grade adenocarcinoma
• Basal Cell Adenocarcinoma
• Adenoid cystic carcinoma
• Acinic Cell Carcinoma

18. Parotid Gland
• Largest serous salivary gland / 25 gms
• Resembles a 3 sided pyramid with apex directed
downwards
4 Surfaces:
• Superior
• Superficial
• Anteromedial
• Posteromedial
Separated by 3 borders:
• Anterior
• Posterior
• Medial

19. Parotid Gland - Relations:
Superior Surface
Small, Concave, Related to
• Cartilaginous part of Ext acoustic meatus
• Post. Aspect of TMJ
• Auriculotemporal Nerve
• Sup. Temporal vessels
Apex
• Overlaps posterior belly of digastric and adjoining part of
carotid triangle
Superficial Surface – Largest; concave
Covered by
• Skin, Superficial fascia containing facial branches of great
auricular N
• Superficial parotid lymph nodes and post fibres of
platysma

20. Applied Anatomy
• Spread of Infection from EAC TO Parotid

21. Parotid Gland - Relations
Anteromedial Surface
• Grooved by posterior border of ramus of
mandible
Related to
• Masseter
• Lateral Surface of TMJ
• Medial pterygoid muscles
• Emerging branches of Facial N
• The facial nerve and parotid duct emerge
from this surface and run forwards deep to
the anterior border

22. Parotid Gland - Relations
Posteromedial Surface is related to
• Mastoid process with sternomastoid and
posterior belly of digastric.
• Styloid process with its attached muscles
(styloglossus, stylohyoid and stylopharyngeus),
which separate the gland from the internal
carotid artery and internal jugular vein within
the carotid sheath.
• Indented by the External Carotid Artery prior
to its entering the gland.
• The facial nerve trunk enters the gland high on
the posteromedial surface between the
mastoid and styloid processes.

23. Anterior border
• Separates superficial surfaced from
anteromedial surface
• Extend from anterior part of the superior surface
to the apex
• Parotid duct
• Terminal branch of facial nerve
• Transverse facial vessels
• Accessory parotid gland

24. Posterior border
• Separates the superficial surface
from the posteromedial
surface.
• Overlies the SCM
Medial border
• Separates the Anteromedial
surface from the posteromedial
surface
• Related to the lateral wall of the
pharynx

25. Capsule
• Formed by Investing layer of deep cervical fascia
• Splits to enclose the gland
• Continuous anteriorly with fascia covering
masseter as parotidomaseteric and extends upto
zygomatic arch.
• Superficial lamina – Thick and adherent is
attached to the zygomatic arch
• Deep lamina – Thin; attached to the styloid
process, the angle & posterior border of ramus
and tympanic plate
• A portion of the deep lamina thickens to form the
stylomandibular ligament which separates the
parotid from the submandibular gland

26. • The fascia is largely tough and inelastic but thins anteriorly.
• Relatively thin fascia over the apex of the gland.
• With in the capsule are superficial parotid Lymph nodes and greater
auricular nerve.

27. Applied anatomy
• Apex - lead to the spread of sepsis into the parapharyngeal space.
• Inflammatory oedema pus and rapidly growing tumors contained within
the capsule will cause it to stretch and become painful.
• Most parotid tumors arise from the superficial lobe and expand towards
the superficial surface
• Deep lobe tumors are limited by the stylomandibular
ligament and expand into the parapharyngeal space.

28. Parotid duct / Stenson’s Duct
• Low cuboidal epithelium surrounded by smooth muscles and fibrous tissue wall.
• Originates within the gland, enveloped by the deep lobe of the parotid; only small
ductules connect the superficial lobe with the duct.
• 5cm length / 0.6mm
• Emerges from the anterior border of the parotid gland and travels across the masseter
muscle.
• Having received the duct from the accessory gland it turns medially at the anterior
border of the masseter.
• It pierces buccinator and runs obliquely between buccinator and the oral mucosa before
entering the oral cavity at the parotid papilla opposite the second upper molar tooth.

29. • The facial nerve and its branches are always observed lateral
to the parotid duct
• The surface marking is the middle of a line between the
intertragal notch of the auricle and the midpoint of the
philtrum

30. Structure within the parotid gland
Arteries
• ECA enters the gland through its posteromedial
surface
• Divides into the maxillary and superficial
temporal artery within the gland
• The maxillary artery leaves the anteromedial
surface
• Superficial temporal artery continues superiorly
to exit the gland from its superior surface.

31. Veins
• Superficial to the maxillary and superficial
temporal arteries lie the corresponding veins
– unite form the retromandibular vein.
• The retromandibular vein emerges from the
lower pole of the gland and divides into two
branches.
• The anterior branch joins the facial vein
before entering the internal jugular vein.
• The posterior branch joins the posterior
auricular vein to form the external jugular
vein.
• The division may occur within the gland and
two branches emerge from the lower pole

32. Facial Nerve
• Exits from cranial cavity through stylomastoid
foramen
• 3 branches at exit point - foramen to styloid muscle,
posterior auricular muscles and posterior belly of
digastric
• Enters the gland through upper part of its posterior
margin of gland.

33. • Nerve branches at pes anserinus (goose foot)
approximately 1.3 cm from stylomastoid foramen.
• Gives 2 main branches
• Tempero facial (Upper)
• Cervicofacial (Lower)

34. Followed by 5 terminal branches
• 1.Temporal
• 2.Zygomatic
• 3.Buccal
• 4.Marginal mandibular
• 5.Cervical

35. Katz and catalano classification of facial
branches
• Type 1- classical type(25%),
subtypes –division and reunion
within the zygomatic and mandibular
branches
• Type2-(14%),buccal branches
subdividedand fuse with zygomatic
branch

36. • Type 3 – 44%, major communication
from buccal branch to others
• Type 4 – (14%), two or more buccal
branches with several anastomosis
with each other and other branches

37. • Type 5- (3%), facial nerve leave the
skull as more than one trunk

38. Surgical landmarks
• 1. Superior (1cm)to upper border of posterior belly of digastric
and in same depth / plane.
• 2. Tragal pointer of Conley – Medical Most end of EAC. Facial
Nerve is (exits the SMF at) 1 cm deep and 1 cm inferior to this
pointer
• 3. Tympanomastoid Suture line is easily palpable as a hard ridge
deep to the cartilaginous portion of the EAC. The facial nerve
emerges a few millimetres deep to its outer edge. Most
consistent precise landmark. TM suture line leads directly to SM
Foramen / Facial nerve (6 to 8 mm deep)
• 4. The styloid process lies deep to the nerve and so should not
be used as landmark.

39. Patey’s Faciovenous plane
• Gland composed of a large superficial and small
deep part, connected by an isthmus around which
facial nerve divides.
Clinical significance:
• Facial nerve must be traced from behind forwards
as it emerges from the stylomastoid foramen and
enters the parotid gland.
• Nerve is surrounded by a leash of veins called
neuro-venous plexus of patey which must be
followed with fine dissection, to surgically divide the
isthmus.

40. • Isthmus of parotid gland runs between
mandibular ramus and post. Belly of digastric
to connect retromandibular portion of
remainder of gland
• The nerve lies superficial to the retromandibular
vein, which is in turn superficial to the external
carotid artery.
• Applied anatomy :The vein can be a useful
radiological landmark for the nerve.

41. • This portion of gland lies in prestyloid compartment
of parapharyngeal space.
• Applied anatomy
• Thus deep parotid tumour push-tonsillar fossa
• Parotid tumour-that involve parapharyngeal space-
dumbbell tumour

42. Blood supply
• Branches of the external carotid artery supply
the gland
• Venous drainage is via the retromandibular
vein into the external and internal jugular vein.

43. Parotid Gland – Nerve Supply
• Parasympathetic
• Secretomotor
• Reach through auriculotemporal nerve

44. Applied Anatomy
• Baillarger's syndrome, Dupuy’s syndrome,
auriculotemporal syndrome, Frey-Baillarger syndrome
• Frey's syndrome often results as a complication of
surgeries of or near the parotid gland or due to injury to
the auriculotemporal nerve, which passes through the
parotid gland in the early part of its course.
• Gustatory Sweating

45. Parotid Gland – Nerve Supply
• Sympathetic Nerves
• Vasomotor
• Derived from the plexus around the middle meningeal artery
• Sensory Fibre
• Derived from the auriculotemporal nerve but the parotid fascia is innervated
by the sensory fibres of Great Auricular nerve

46. Parotid Gland – Lymph Nodes:
• Lie partly in the superficial and partly in the deep fascia over the parotid
gland
• Drainage:
• Temple
• Side of the scalp
• External acoustic meatus
• Middle ear
• Parotid gland
• Upper part of the cheek
• Parts of eyelids and orbit

47. Accessory parotid gland
• Pars accesoria or socia parotidis
• Separate part of the gland usually lying on the masseter muscle between
the parotid duct below and the zygomatic arch above.
• Noted in 20% of people
• Typically lies cranial to stensen’s duct

48. Submandibular Gland
• Second largest
• Size of walnut
• Lies in the submandibular triangle
• Weighs : 7–16 g
• Roughly j shaped divided by
mylohyoid
• 1.Superficial (larger)
• 2.Deep (smaller)

49. Superficial part
• Fills the digastric triangle
• Extend upwards deep to the mandible up to the mylohyoid
line
• 3 surfaces
– Inferior
– Lateral
– Medial
• Covered by skin, platysma and a fibrous capsule,
derived from the deep cervical fascia.

50. • The capsule runs from the greater
cornu of the hyoid bone to periosteum
of the mandible along the mylohyoid
line medially, and the lower border of
the body of the mandible laterally.
• The fascia is crossed by the facial
vein, the cervical branch of the
facial nerve and the marginal
mandibular branch of the facial
nerve.

51. Lateral Surface
• lies adjacent to the body of the
mandible in the mandibular fossa and
the origin of the medial pterygoid.
• The facial artery enters or deeply
grooves the gland posteriorly, after
emerging from deep to the superior
margin of the posterior belly of the
digastric.
• It initially lies deep to the gland before
turning anterolaterally to emerge
between the gland and the lower
border of the mandible.

52. Medial Surface
• Lies on the surface of mylohyoid anteriorly
with the nerve to mylohyoid and submental
vessels.
• Posteriorly the gland overlies hyoglossus, the
lingual nerve with its submandibular
ganglion, hypoglossal nerve, stylohyoid and
posterior belly of digastric.

53. Inferior Surface
• Overlaps stylohyoid and the posterior belly of the digastric.

54. Deep Part
• Small part
• Gland lies between mylohyoid and hyoglossus.
• Posteriorly continuous with the superficial part around the posterior border
of the mylohyoid.
• Anteriorly : extend up to the posterior end of the sublingual gland
• Relation
• Laterally : mylohyoid
• Medially : hyoglossus
• Above : lingual nerve with submandibular ganglion
• Below : hypoglossal nerve

55. Submandibular duct(Wharton's duct)
• Approximately 5 cm long
• Mean duct diameter : 0.5 - 1.5 mm
• It is formed by the coalescence of
numerous ducts within the superficial part
of the gland
• Emerging from the medial surface of this
part of the gland
• Traversing the deep part before running
anteriorly along the floor of the mouth

56. • It emerges on the summit of the sublingual papilla adjacent to the lingual
frenulum after passing between the sublingual gland and genioglossus.
• While running forwards on hyoglossus, it lies between the hypoglossal
and lingual nerves.
• The lingual nerve crosses the duct laterally at the anterior edge of
hyoglossus before branches of the nerve emerge on the medial surface of
the duct.

57. Nerve Supply
• The sympathetic innervation : superior cervical ganglion via the lingual
artery.
• Presynaptic parasympathetic innervation : via the lingual nerve, a branch
of the mandibular division of the Vth cranial nerve to the submandibular
ganglion.
• Innervation is initially from the superior salivatory nucleus in the pons
passing through the nervus intermedius and carried by the chorda
tympani nerve.

58. Superior salivatory nucleus
Nervus Intermedius
Facial nerve
Chorda tympani
Lingual nerve,br of V3 Submandibular
ganglion
Post ganglionic fibers
Submandibular gland

59. Arterial supply
• Submental branch of facial artery(br.
Of ext. carotid art) forms groove in
deep part of the gland then curve up
around the inf. Margin of mandible to
supply the face.
Venous drainage
• Anterior facial vein deep to marginal
mandibular vein
Lymphatic drainage
• Into the deep cervical group,
particularly the jugulo- omohyoid
nodes.

60. Applied anatomy
• 80-90% of sialolithiasis in
submandibular gland
• 85% in Wharton's duct
• Complete ductal
obstruction result in atrophy of gland
• Partial obstruction glandular
mucocele

61. Applied anatomy
• An important anatomical relationship is that the marginal mandibular
nerve passes lateral to the vein and, therefore, dissecting deep to the
vein, can be used to preserve or identify the nerve.
• Perivascular L.N near the facial artery are often involved with cancer
originating in submandibular gland and nodes should be removed with
submandibular resection.

62. Submandibular Gland – Clinical Implications:
• The chorda tympani supplying secretomotor fibers to submandibular and
sublingual glands lies medial to the spine of sphenoid
• The auriculotemporal nerve supplying secretomotor fibers to parotid is related to
the lateral aspect of the sphenoid
• Injury to spine may involve both these nerves with loss of secretion from all 3
salivary glands

63. Submandibular Gland – Clinical Implications:
• Sialadenitis due to calculi :
• Disease starts with acute bacterial Sialadenitis which occurs secondary to
obstruction
• Submandibular gland has a poor capacity for recovery following obstruction

64. • Sialadenitis due to calculi :
• Calculi are more common in the submandibular gland because of the following
reasons
• Higher mucin content
• Higher Calcium and phosphate content
• Non dependent drainage
• Kinking of Wharton’s duct

65. Sublingual gland
• Smallest of major salivary gland
• Wt.- approx. 4 gm
• Almond shaped
• Lies deep to floor of mouth mucosa
between mylohyoid muscle and body of
mandible close to symphysis (sublingual
fossa)
• Wharton's duct and lingual nerve pass
between sublingual gland and
genioglossus muscle.

67. • Has no true capsule
• Lack single dominant duct- drained by
approx.
• 10 small ducts(duct of rivinus) which
open along the sublingual gland on the
floor of mouth
• Occasionally several more ant duct
may join to form common duct
(Bartholin duct) which typically opens
into Wharton's duct

68. Innervation
• Sympathetic-cervical chain via facial artery
• Parasympathetic-submandibular ganglion
Arterial Supply
• Sublingual branch of Lingual artery
• Submental branch of facial artery
Venous Drainage – reflects arterial supply
Lymphatics – Submandibular nodes

69. Ranula:
• Translucent cystic swelling with a bluish tinge
situated on one side of frenulum linguae
• Almost always unilateral
• Painless, slow growing ,soft, movable mass
located at the floor of the mouth
• When a ranula herniates through the mylohyoid &
extends into the neck so that it can be palpable in
the submandibular triangle, its called a Plunging
Ranula

70. Minor Salivary Glands
• They are located beneath the oral epithelium in almost all parts of the oral cavity
except in the gingiva, ant. Hard palate and ant. 2/3rd of tongue dorsum
• 600 – 1000 in number present in small clusters of secretory units
• Classified according to their anatomic location
• Continuous slow secretory activity
• Often supersede the activity of major salivary glands at night

71. Minor Salivary Glands:
• Glands of Blandin and Nuhn
• Mostly Located near apex of tongue, some also found
posteriorly
• Chiefly mucous
• Anterior glands open on ventral surface near lingual
frenum
• Posterior glands open on tongue dorsum

72. Glands of Von ebner
• Located on posterior aspect of tongue
• Exclusively serous
Functions:
• Washout of trough papillae
• Readying taste receptors for a new stimulus
• Antibacterial activity (lysozyme and peroxidase)
• Lipolytic activity (lingual lipase) with significant
activity in newborn when pancreatic lipase activity is
low

73. Mucocele :
• Traumatized or obstructed salivary duct
• Extravasation mucoceles most commonly occur on
the lower lip, buccal mucosa, tongue and floor of the
mouth
• Retention mucoceles commonly occur on the palate
Minor Salivary gland tumor :
• Present either as a mucous retention cyst or as
malignant tumor
• Since they are submucosal, they start as a
submucosal nodule which helps them to differentiate
from carcinoma lip/buccal mucosa etc.
• Presence of an ulcer - Malignancy
• Treatment of benign cyst/tumor is by simple excision
while malignant tumors require wide excision

74. Physiology of salivary glands
• Salivary glands produce saliva, which plays an important role in the
maintenance of oral health.
• The largest portion of total saliva volume is produced by three paired
major salivary glands: the parotid, the submandibular and the sublingual
salivary glands.
• In addition, there are 600–1000 minor salivary glands present in the
mucosal lining of the oral cavity and oropharynx that also contribute to
total saliva production.

75. Types of salivary gland secretion

76. Composition of saliva
• 99.5%-water
• Proteins
• Glycoproteins
• Electrolytes
• High in k+(7*plasma) HCO3(3*plasma), Ca, P
,Cl, thiocynate
and urea
• Low in Na+(1/10*plasma)
• pH of 5.6–7.4

78. Functions of Saliva

79. Phases of salivary secretion
• Active process in 2 phase
• 1.Primary phase- occur in acinar cells (product similar in composition
and osmolality to plasma)
• 2.Ductal secretion- result in hypotonic salivary fluid with decreased
sodium and increased potassium concentrations.

80. Mechanism of Salivary Secretion
• As in all secretory epithelia, fluid transport in salivary gland cells - osmotically by
transepithelial concentration gradients.
• Three mechanisms that act concurrently resulting in the production of primary
salivary fluid secretion.
• The first mechanism depends on the combined action of four membrane
transport systems
– Na+ -Cl− co-transporter that is located in the basolateral membrane of the
acinar cells
– Basolateral Ca++-activated K+ channel
– An apical conductive pathway for Cl−, which is presumably a Ca++ -activated
Cl− channel
– Basal Na+ / K+ ATPase

81. In resting state, K+ and Cl- concentration gradients, where the intra cellular concentration
exceeds the extracellular concentration created by Na+/K+ ATPase and Na+/K+/2cl- co
transporter
Secretary stimulation via parasympathetic nervous system, leads to rise in intracellular
Ca++ conc
Results in opening of basolateral K+ channel and apical Cl- channel
K+ and Cl- then flow along respective concentration gradient K+ into ECS and Cl- into duct
lumen
Resulting in accumulation of Cl- ions into primary salivary fluid
As a consequence of this a net negative charge of primary salivary fluid, which promotes
the transport of sodium ions from interstitium into duct lumen

82. Resulting osmotic gradient for NaCl, in turn provokes the transepithelial movement of
water from interstitium to the lumen
Continued parasympathetic input results in continued transepithelial Cl influx and
increases saliva volume
Cessation of parasympathetic stimulus – fall in Ca concentration to resting levels, closure of
K+ and Cl- channels and return of the cell to its resting state

83. Second mechanism also involves the creation of an intracellular Cl- concentration gradient
created by Cl-/HCO3 exchanger acting with Na+/H+ exchanger
A fall in intracellular chloride concentration as a result of parasympathetic stimulated KCL
loss – entry of more Cl- in exchange of HCO3-
Acidification of the cytoplasm that results from this bicarbonate loss is buffered by Na+/H+
exchanger
Which drives the extracellular to intracellular
sodium gradient generated by Na+/K+ ATPase
to drive protons out of the cell

84. Third mechanism – active bicarbonate secretion
CO2 enters the acinar cells across the basolateral membrane and is converted to HCO3 which is also lost
across the apical membrane via an anion channel which is possibly the same as the Cl-/HCO3 exchanger
Involves the cl secretion as in second mechanism
Acidification is rectified by the expulsion of a proton by the basolateral Na+/H+ exchanger.

85. MECHANISMS OF ION TRANSPORT IN
SALIVARY ACINI

86. Factors affecting salivary flow
• Age – postmenopausal women
• Drugs – TCA, neuroleptics, anti parkinsonian agents,
antiemetics, antihistamine
• Disease- autoimmune sialadenitis, HIV, radiation damage, graft
versus host disease, sarcoidosis, iron overload, amyloidosis,
and type v hyperlipoproteinemia
• Anxiety and depression induced xerostomia

88. Salivary flow
• The average volume of saliva secreted from the major salivary gland in
a 24-hour period is 1–1.5 liters.
• Most saliva is secreted during mastication.
• The basal salivary flow rate is 0.001–0.2 ml / minute / gland
• Stimulated salivary flow rate increases to 0.18–1.7 ml / minute / gland
• In contrast, the salivary flow from the minor salivary glands is independent of
stimulation and constitutes 7–8% of total salivary output.
• The saliva produced by minor salivary glands is rich in mucin and is primarily
responsible for maintaining oral mucosal lubrication.

89. • In an unstimulated state the contribution of measured
Salivary gland is:
• Submandibular gland: 69%
• Parotid gland: 26%
• Sublingual gland: 5%
• In a stimulated phase the relative contributions of major
salivary glands are:
• Parotid gland: 69%
• Submandibular gland: 26%
• Sublingual gland: 5%

90. Collection of saliva
• The collection of saliva is performed under three
circumstances:
• Unstimulated flow of total saliva
• Stimulated flow of total saliva
• Stimulated or unstimulated flow of an individual gland.

91. • Systemic or local sialagogues may be used to stimulate flow.
• Systemic salivary sialagogue is pilocarpine, a parasympathomimetic,
although this is rarely used outside research.
• A commonly used protocol involves the dropwise application of 5%
citric acid solution on the dorsum of the tongue.
• As for collecting saliva, a variety of methods are used.
– Spitting
– Drainage
– Suction
– cotton wool rolls.

92. Collection of parotid gland saliva
• Collected by cannulating parotid duct with polythene
catheter or suction cup.
• Suction cup(Carlson-Crittenden cup/Lashley’s cup)

93. Collection of submandibular and sublingual
gland saliva
• Saliva produced by the submandibular and sublingual glands
is typically collected using a syringe.
• Individual gland production is technically impossible due to the
close proximity of duct orifices in the anterior floor of mouth or
more pertinently by the numerous potential communicating
channels between the duct systems of all four glands.

94. Radioisotope salivary function test
• 99mTc pertechnicate is used for study of salivary gland
function.
• With scintigraphy objective measure of its uptake,
concentration and excretion can be made
• Both parotid and submandibular gland can be studied at same
time.

95. Salivary assays in diagnosis

96. THANK YOU