小结
定义
病史和体格检查
关键诊断因素
- fever
- pain and dysphagia
- facial swelling
- recurrent painful swellings
- exudates of pus from salivary gland opening
- use of xerostomic medications
- mandibular trismus
- respiratory distress (stridor, use of accessory muscles, nasal flaring, wheeze)
- cranial nerve palsy
- connective tissue disorder or Sjogren syndrome
其他诊断因素
- episodic swelling during eating
- recent surgical intervention under general anesthetic
- dry eyes and mouth
- oral candidiasis
- iodine contrast exposure
- recurrent painless swellings
- displacement of earlobe
- prodrome of tingling in the affected gland
- swelling on the hard palate
危险因素
- volume depletion and malnutrition
- immunosuppression
- Sjogren syndrome
- connective tissue diseases
- women aged 50 to 60
- general anesthesia
- xerostomic medications
- sialolithiasis
- chronic mechanical obstruction and/or multiple bouts of acute inflammation
- trauma (cheek biting)
- dental/orthodontic procedures
- sialectasis, diverticuli, and strictures
诊断性检查
首要检查
- culture and sensitivities of exudate from duct
- CBC
- facial radiographs (occlusal and/or soft tissue films)
需考虑的检查
- ultrasound of affected gland
- CT scan
- digital subtraction sialography
- MR sialography
- scintigraphy using radioisotope sodium pertechnetate Tc-99m
- SSA/anti-Ro, SSB/anti-La antibodies
- antinuclear antibodies
- rheumatoid factor
- fine needle aspiration cytology of affected gland
- MRI
- minor salivary gland biopsy
- IgG4 and IgE
- major salivary gland biopsy
- sialoendoscopy
治疗流程
signs of airway compromise
acute bacterial sialadenitis (nonobstructive)
obstructive sialadenitis
autoimmune sialadenitis
subacute necrotizing sialadenitis
chronic sialadenitis: recurrent or sclerosing (<3 times/year or nonsevere)
recurrent sialadenitis: any cause (>3 times/year or severe attacks)
撰稿人
作者
Chris Avery, MD, MChir, FDSRCS, FRCS, FRCS (OMFS)
Consultant Oral and Maxillofacial Surgeon
Honorary Associate Professor Senior Lecturer
University Hospitals of Leicester NHS Trust
Leicester
UK
利益声明
CA declares that he has no competing interests.
鸣谢
Dr Chris Avery would like to gratefully acknowledge Dr Alfredo Aguirre, Dr Michael N. Hatton, and Dr Ernesto de Nardin, previous contributors to this topic. AA, MNH, and EDN declare that they have no competing interests.
同行评议者
Issac van der Waal, DDS, PhD
Professor of Oral Pathology
Head of the Department of Oral and Maxillofacial Surgery and Oral Pathology
VU University Medical Centre and Academic Centre for Dentistry
Amsterdam
The Netherlands
利益声明
IVDW declares that he has no competing interests.
Michael D. Turner, DDS, MD, FACS
Assistant Professor
New York University College of Dentistry
Department of Oral and Maxillofacial Surgery
Department of Periodontics and Implant Dentistry
New York University School of Medicine
New York
NY
利益声明
MDT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Fattahi TT, Lyu PE, Van Sickels JE. Management of acute suppurative parotitis. J Oral Maxillofac Surg. 2002;60:446-448. 摘要
Kraaij S, Karagozoglu KH, Forouzanfar T, et al. Salivary stones: symptoms, aetiology, biochemical composition and treatment. Br Dent J. 2014 Dec 5;217(11):E23.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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