The document discusses various salivary gland diseases including functional disorders like sialorrhea and xerostomia, obstructive disorders like sialolithiasis, non-neoplastic disorders such as acute and chronic sialadenitis, and neoplastic disorders including adenomas, mucoepidermoid tumors, carcinomas, and malignant lymphomas. It also covers sinus diseases such as acute and chronic sinusitis, their causes, symptoms, treatments, and potential complications.

1. Salivary Gland Diseases Dr shabeel pn

2. Salivary Gland Diseases Functional disorders Obstructive disorders Non-neoplastic disorders Neoplastic disorders

3. Functional Disorders Sialorrhea (Increase in saliva flow) Psychosis, mental retardation, certain nuerologicval diseases, rabies, mercery poisoning Xerostomia (Decrease in saliva flow) Mumps, sardoidosis, Sjogrens, syndrome, lupus, post-irradiation

4. Funtional Disorders Mucocele Secondary to trauma 70% occur in lower lip Excisional biopsy usually curative Ranula Sublingual salivary gland mucocele Treatment should include removal of sublingual gland

5. Obstructive Disorders Sialolithiasis 92% occur in submandibular gland 6% in parotid gland Multiple occurrence in same gland is common

6. Submandibular Gland Lithiasis Diagnosis Pain and sudden enlargement of gland while eating Palpation of stone submandibular duct Occlusal radiograph (80%)

7. Submandibular Gland Lithiasis Treatment Can be removed transorally if in duct and easily palpable If in gland and gland is damaged, then gland should be removed

8. Parotid Lithiasis Diagnosis Based on history Swelling during meals Bimanual palpation of painful gland 40% non-radiopaque Most parotid stones are multiple

9. Partiod Lithiasis Treatment Stones in extraglandular portion of duct can be removed transorally Intraglandular stones removed from extraoral approach

10. Non-Neoplastic Disorders

11. Acute Sialadentis Etiology Viral - ( Mumps) Bacterial

12. Acute Sialadentis Bacterial - swelling and dehydration, xerostomia, failure of secretion with ascending infection (Staph aureus, Strep pyogenes, most common infective organism) Painful swelling parotid gland, overlying skin red, shiny & tense, pus from parotid duct

13. Acute Sialadentis Treatment Culture pus Appropriate antibiotic Supportive therapy Fluids Heat Salivary stimulants

14. Chronic Sialadenitis Chronic recurrent parotitis Age 3-6 Caused by Strep viridans May spontaneously heal during puberty

15. Necrotizing Sialometaplasis Benign inflammatory condition Usually involves in minor salivary gland of hard palate Will often simulate a malignant condition No definite etiology 1-3 cm ulcer heals spontaneously

16. Neoplastic Disorders

17. Salivary Gland Tumors Adenomas (Epithelial) Pleomorphic adenoma Monomorphic adenoma Adenolymphoma Oxyphil adenoma Other types

18. Salivary Gland Tumors Mucoepidermoid tumor Acinic cell tumor

19. Salivary Gland Tumors Carcinomas Adenoid cystic carcinoma Adenocarcinoma Epidermoid carcinoma Undifferentiated carcinoma Carcinoma in pleomorphic adenoma

20. Non-epithelial Malignant lymphoma Unclassified tumors

21. Salivary Gland Tumors Allied conditions Benign lymphoepithelial lesions Sialosis Oncocytosis

22. Salivary Gland Tumors 80 % occur in parotid gland 5-10 % occur in the submandubular gland 1 % occur in sublingual gland 10-15% occur in the minor salivary glands

23. Incidence of Malignancy According to Site Sublingual 70% Submandibular 40% Parotid 20 %

24. Clinical Classification Benign (seldom recurrent) Adenolymphoma (Wharthins Tumor) Oxyphil adenoma (Oncocytoma) Other types of Monomorphic adenoma

25. Clinical Classification Benign (often recurrent) Pleomorphic adenoma (mixed tumor) Mucoepidermoid tumor ( low-grade) Acinic cell tumor (same)

26. Clinical Classification Malignant Carcinoma in pleomorphic adenoma Adenoid cyctic carcinoma Adinic cell tumor Mucoepidermoid tumor (high-grade)

27. Clinical Classification Malignant Squamous carcinoma Adenocarcinoma, other types Undifferentiated carcinoma

28. Sinus Disease

29. Sinusitis Acute Chronic

30. Acute Sinusitis Deep-seated ache which rapidly increases in intensity over evolved sinus May cause pain in upper molar teeth Pain is generally accompanied by increase in temperature Radiographic evidence of “air fluid level”

31. Acute Sinusits Treatment (early in course) Humidification Antibotics Systemic decongestants and nasal spray Refractory cases Surgical intervention

32. Chronic Sinusitis Recurrent bouts of sinus infection Low-grade in nature Multiple causes Viral, bacterial, fungal, allergic, anatomic Radiographis findings of thickening of mucosa, polys

33. Chronic Sinusitis Treatment During acute phase- same as acute sinusitis If physical obstruction of ostic, septoplasty or Caldwell-Luc with nasal antrostomy

34. Chronic Sinusitis If allergy related: Avoidance of precipitating allergens Short course of topical Decongestants Allergy testing and desensitization therapy

35. Complications of Sinusitis Orbital cellulitis Can result in blindness secondary to ischemia of the retina or retinal detachment Cavernous sinus thrombosis Can result in blindness Deficits of the central nervous system and death