Salivary Glands Disorders - Shanyar：唾液腺疾病的shanyar.ppt

Diagnostic Evaluation Leukocytopenia + relative lymphocytosis Increased serum amylase Viral serology : antibodies Treatment Supportive Fluid Anti-inflammatory analgesics Complications Orchitis, testicular atrophy and sterility 20% of young men Meningitis in 10% Oophoritis in 5% Pancreatitis in 5% Hearing loss 5% - Usually permanent - 80% unilateral Allergic sialadenitis Caused by drugs or allergens Clinical presentation: Acute salivary gland enlargement Itching over the gland With/without rash Allergic sialadenitis Treatment: - Self-limited disease - Supportive therapy - Avoid allergen - Hydration Sialolithiasis ( salivary stones) One or more round or oval calcified structures in the duct of the major or minor salivary glands Salivary calculi Submandibular Most common Pain subsides before swelling. Recurrent painful swelling at mealtime Acute subacute infection Persistent obstruction damages the gland making it harder and tender Salivary calculi Skin is red, oedematous , hot and tender if infected Bimanual palpation Diagnostics: Plain occlusal film Sialography Demonstrate the lumen of the ducts for stone, tumor, or stricture. Sialolithiasis Treatment Conservative: antibiotics and anti-inflammatory: spontaneous stone passage. Excision: - Lithotripsy - sialendoscopy - manipulation fails then a surgical cut is made into duct Gland excision - the stone is within the gland - the gland is severely damaged by chronic infection. Granulomatous conditions 1- Tuberculosis: - Xerostomia - Salivary enlargement 2- Sarcoidosis: - Severity and duration of disease varies - Mild improvement noticed with steroid therapy Sjogren Syndrome Autoimmune condition causing progressive degeneration of salivary and lacrimal glands connective tissue disorder, such as rheumatoid arthritis Clinical picture Mostly affects the parotid gland Persistent / intermittent gland enlargem. Bilateral, non-tender, firm, and diffuse swelling ? saliva and altered saliv