The inflammation and enlargement of one or several major salivary glands. It most commonly affects parotid and submandibular glands.
Bacterial infection can supervene if salivary flow is diminished by illness or medication, or is obstructed by a sialolith (salivary stone). Most commonly caused by Staphylococcus aureus.
Intermittent painless unilateral or bilateral swellings without accompanying signs of infection may be idiopathic or due to an underlying condition, such as ductal stenosis or autoimmune disease.
Chronic sclerosing sialadenitis presents as a painless unilateral swelling that can mimic tumours. Biopsy is required for diagnosis.
Airway compromise is an important potential consequence of acute glandular swelling.
Sialadenitis denotes inflammation and swelling of the parotid, submandibular, sublingual, or minor salivary glands. Aetiology includes bacterial or viral infection, obstruction, or autoimmune causes. Acute bacterial sialadenitis is characterised by rapid onset of pain and swelling. In contrast, chronic sialadenitis is characterised by intermittent, recurrent episodes of tender swelling. Painless swellings (unless secondarily infected) classically occur in autoimmune sialadenitis (i.e., Sjogren's syndrome) and may be unilateral or bilateral. Chronic sclerosing sialadenitis is typically unilateral and may mimic a tumour.
History and exam
- episodic swelling during eating
- use of xerostomic medications
- recent surgical intervention under general anaesthetic
- dry eyes and mouth
- oral candidiasis
- connective tissue disorder or Sjogren's syndrome
- recurrent painless swellings
- displacement of earlobe
- prodrome of tingling in the affected gland
- swelling on the hard palate
- volume depletion and malnutrition
- Sjogren's syndrome
- connective tissue diseases
- women aged 50 to 60
- general anaesthesia
- xerostomic medications
- chronic mechanical obstruction and/or multiple bouts of acute inflammation
- trauma (cheek biting)
- dental/orthodontic procedures
- sialectasis, diverticuli, and strictures
Consultant Oral and Maxillofacial Surgeon
Honorary Senior Lecturer
University Hospitals of Leicester NHS Trust - Leicester Royal Infirmary
CA declares that he has no competing interests.
Dr Chris Avery would like to gratefully acknowledge Dr Alfredo Aguirre, Dr Michael N. Hatton, and Dr Ernesto de Nardin, previous contributors to this monograph. AA, MNH, and EDN declare that they have no competing interests.
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
IVDW declares that he has no competing interests.
New York University College of Dentistry
Department of Oral and Maxillofacial Surgery
Department of Periodontics and Implant Dentistry
New York University School of Medicine
MDT declares that he has no competing interests.
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