Salivary Gland Disorders
The salivary glands make saliva and release it into the mouth. There are three pairs of major salivary glands, relatively large:
Parotid glands, are located on top of each cheek near the ear. The duct of each parotid gland empties into the cheek, near the molars (grinding) of the upper jaw.
Submandibular glands: on the floor of the mouth, there are ducts that empty behind the lower front teeth.
Sublingual glands, behind the tongue, there are ducts that empty into the floor of the mouth.
In addition to these major glands, there are 600-1000 minor salivary glands, tiny scattered throughout the mouth and throat. They are located under the skin moist lining the upper lip, upper cheeks, palate, the back of the throat, the posterior portion of the tongue, pharynx, and sinuses.
Some of the salivary gland disorders most common include:
- Sialolithiasis (salivary gland stones) sometimes form tiny calcium stones called salivary stones or stones. Although the exact cause of these calculations are sometimes associated with dehydration, which thickens the saliva; with decreased food intake, which decreases the demand for saliva or medications that decrease saliva production, including certain antihistamines, blood pressure medications and psychiatric drugs. Some estimates are housed within the gland and cause symptoms. In other cases, a stone blocks the gland duct partially or completely. When this happens, the gland typically causes pain and inflamed (swollen) and saliva flow is partially or completely blocked. This may be followed by an infection called sialadenitis.
- Sialadenitis (bacterial infection of a salivary gland) is a painful infection that is usually caused by staphylococci, streptococci, Haemophilus influenzae or anaerobic bacteria. Although it is very common among elderly patients with salivary gland stones, sialadenitis also can occur in infants during the first weeks of life. Many factors increase the risk of this condition, including dehydration, recent surgery, premature babies, malnutrition, eating disorders, chronic illness, cancer, certain medications (antihistamines, diuretics, psychiatric medications, beta blockers, barbiturates and certain occupations (trumpet playing and the glass blowing). Without proper treatment, sialadenitis can become a serious infection, especially in frail or elderly people.
- Viral infections: Viral infections sometimes lodge in the salivary glands, causing swelling of the face, pain and difficulty eating. The most common example is mumps. Similar symptoms may be caused by other viral diseases, parainfluenza virus, Coxsackie virus, ECHO virus and cytomegalovirus.
- Cysts (tiny sacs filled with pus): Babies are sometimes born with cysts in the parotid gland because of problems related to ear development before birth. Later they can form other types of cysts in the major and minor salivary glands as a result of traumatic injuries, infections, kidney or salivary gland tumors. One of the most common types is a mucocele, mucus-filled cyst that often appears in the lower lip.
Benign tumors (noncancerous tumors) About 80 percent of all salivary tumors occur in the parotid gland and most are benign (not cancerous). The most common type of benign tumor of parotid gland pleomorphic adenoma, usually appears as a slight increase, swelling with pain in the back of the jaw, just below the earlobe. More than 95 percent of all salivary gland tumors occur in adults. Risk factors include radiation exposure and possibly smoking.
- Malignant (cancerous tumors) Salivary gland cancers often occur in people 50 to 60 years of age. They can be either low-grade tumors (less aggressive) and advanced tumors (more aggressive). The only known risk factors for cancers of the salivary glands are Sjogren’s syndrome and exposure to radiation, although smoking may also play a role.
- Sjogren syndrome: a chronic autoimmune disorder in which the body’s immune defenses attack the salivary glands, lacrimal glands (glands that produce tears), and occasionally the skin sweat and sebaceous glands. In some cases, the disease also affects the lungs, liver, vagina, pancreas, kidneys and brain. Most people with this disease are women who first develop symptoms during middle age. In about 50 percent of cases, the disease occurs with rheumatoid arthritis, lupus erythematosus (lupus), scleroderma or polymyositis.
- Sialadenosis (non-specific enlargement of the salivary gland). Sometimes the salivary glands are enlarged and no signs of infection, inflammation or tumor. This nonspecific enlargement, called sialadenosis, most affects the parotid glands and its cause remains unknown. The sialadenosis may develop in obese, pregnant or nursing women and people with malnutrition, eating disorders, alcoholic cirrhosis, renal (kidney), thyroid problems or other diseases.
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