Dr.5th🦷🎓

Acinic cell carcinoma Malignant tumor, 90-95% in the parotid gland, treated by superficial parotidectomy with facial nerve preservation if possible, or total gland removal for submandibular gland tumors

Adenoid cystic carcinoma Malignant tumor, common in submandibular and minor salivary glands, spreads along nerve sheaths, frequent late distant metastases, local recurrences, low long-term survival rates, treated by radical surgical excision

Mucoepidermoid carcinoma Malignant tumor, common in children

Other benign salivary gland tumors Monomorphic adenoma Papillary cystadenoma lymphomatosum (Warthin's tumor) Oncocytoma Basal cell adenoma Canalicular adenoma Myoepithelioma Sebaceous adenoma Ductal papilloma

Pleomorphic adenoma Most common benign tumor, majority in the parotid glands, histologically composed of epithelial and mesenchymal elements, treated by surgical removal with adequate margins

Salivary gland tumors 80% of tumors - parotid glands<|>10 to 15% of tumors - submandibular glands<|>80% of parotid gland tumors - benign<|>50% of submandibular and minor salivary gland tumors - benign<|>More than 60% of sublingual gland tumors - malignant

Systemic conditions with salivary gland involvement Metabolic conditions (Diabetes, Anorexia Nervosa/Bulimia, Chronic Alcoholism, Dehydration) Medication-induced salivary dysfunction Immune conditions (Sjogren's syndrome, Mikulicz's disease) Granulomatous conditions (Tuberculosis, Sarcoidosis)

Complications of bacterial sialadenitis Facial nerve palsy Sepsis Mandibular osteomyelitis Internal jugular vein thrombophlebitis Respiratory obstruction

Treatment of bacterial sialadenitis 1. Resolution of signs and symptoms of infection (heat application, anti-inflammatory and analgesics) 2. Elimination of the causative bacteria (Antibiotics - oral hygiene products) 3. Rehydration (fluids - medications implicated in salivary gland hypofunction should be discontinued) 4. Elimination of obstruction where present (glandular massage -sialogogues) 5. Antibiotics should include coverage for S. aureus, oral polymicrobial aerobic, anaerobic infections, and P-lactamase-producing bacteria (anti-Staphylococcal penicillin, P-lactamase inhibitor, or a first-generation cephalosporin, or azithromycin with metronidazole for those with a penicillin allergy) 6. Antibiotic therapy may need to be modified later based on culture results

Differentiating between viral and bacterial parotitis Viral infections are bilateral, affect younger patients, and do not involve purulent drainage<|>In suppurative parotitis, systemic symptoms follow the development of a symptomatic gland, while the order is usually reversed in viral parotitis

Diagnosis of bacterial sialadenitis 1. Bacterial parotitis is largely a clinical diagnosis 2. If purulent discharge can be expressed from the duct orifice, samples should be cultured for aerobes, anaerobes, fungi, and mycobacteria

Clinical presentation of bacterial sialadenitis 20% of the cases - bilateral infections Complaints of fevers, chills, malaise, trismus, and dysphagia Dry oral mucosa The involved gland is enlarged, warm, painful, indurated, and tender to palpation If Stensen's duct is involved, it may appear erythematous and edematous, with erythema of the overlying skin In approximately 75% of cases, purulent discharge may be expressed from the orifice

Risk factors for bacterial sialadenitis Dehydration Xerogenic drugs Salivary gland diseases Nerve damage Ductal obstruction Irradiation Chronic diseases such as diabetes mellitus and SS Bacterial parotitis following surgery under general anesthesia

Bacterial Sialadenitis Most frequently in the parotid glands Less in the submandibular and sublingual glands due to the antimicrobial activity of mucin, inhibiting bacterial attachment to the epithelium of the salivary ducts, and the serous parotid gland saliva containing less lysosomes, IgA antibodies, and sialic acid Tongue movements tend to clear the floor of the mouth and protect Wharton's duct, while the orifice of Stensen's duct is located adjacent to the molars, where heavy bacterial colonization occurs

Bacterial Sialadenitis Acute bacterial sialadenitis<|>Repeated infections - chronic bacterial sialadenitis

Prevention of mumps The MMR vaccine will prevent mumps, measles, and rubella<|>The MMR vaccine is given to an infant when they are just over 1 year old and again, as a booster, just before they start school

Tests and diagnosis of mumps 1. Take a sample of blood, urine, or saliva to confirm diagnosis 2. Take a sample of CSF (cerebrospinal fluid) from the spine for testing - this is usually only in severe cases

Complications of mumps Orchitis (1 in 5 adult males, rarely results in infertility) Oophoritis (1 in 20 adult females, rarely results in infertility) Viral meningitis (the rarest of the common complications) Pancreatitis (in 1 out of 20 cases) Mumps in the first 12-16 weeks of the pregnancy (slightly increased risk of miscarriage) Encephalitis (can be fatal) Hearing loss (the rarest)

Treatment for mumps 1. No anti-viral medications 2. Current treatment can only help relieve the symptoms until the infection has run (2 weeks) 3. Individuals infected are contagious for 15 days (6 days before the symptoms start to show, and up to 9 days after they start) 4. Consume plenty of water (avoid fruit juices - stimulate the saliva - pain) 5. Place something cold on the swollen area to alleviate the pain 6. Eat mushy or liquid food 7. Sufficient rest and sleep 8. Gargle warm salt water 9. Take painkillers such as acetaminophen or ibuprofen

Mumps signs and symptoms 1. Initially, flu-like symptoms (1-2 days of malaise, body aches, headache, loss of appetite and/or nausea, general fatigue, fever (low-grade), anorexia) 2. Followed by non-purulent gland enlargement 3. Over the next few days, glandular swelling increases (the swelling happens in waves), lasting about one week 4. Painful and swollen parotid glands causing the person's cheeks to puff out 5. Person's tonsils can get pushed to the side 6. Pain when swallowing 7. Fever (up to 103 degrees Fahrenheit) 8. Dry mouth 9. Pain in joints