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Sialadenitis

Última revisión: 2 Dec 2025
Última actualización: 19 Jul 2022

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • 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
Todos los datos

Otros factores de diagnóstico

  • 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
Todos los datos

Factores de riesgo

  • 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
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • culture and sensitivities of exudate from duct
  • CBC
  • facial radiographs (occlusal and/or soft tissue films)
Todos los datos

Pruebas diagnósticas que deben considerarse

  • 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
Todos los datos

Algoritmo de tratamiento

Inicial

signs of airway compromise

Agudo

acute bacterial sialadenitis (nonobstructive)

obstructive sialadenitis

autoimmune sialadenitis

subacute necrotizing sialadenitis

En curso

chronic sialadenitis: recurrent or sclerosing (<3 times/year or nonsevere)

recurrent sialadenitis: any cause (>3 times/year or severe attacks)

Colaboradores

Autores

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

Divulgaciones

CA declares that he has no competing interests.

Agradecimientos

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.

Revisores por pares

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

Divulgaciones

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

Divulgaciones

MDT declares that he has no competing interests.

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Referencias

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Artículos principales

Fattahi TT, Lyu PE, Van Sickels JE. Management of acute suppurative parotitis. J Oral Maxillofac Surg. 2002;60:446-448. Resumen

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.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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