When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Sialadenitis

最后审阅: 12 Dec 2025
最后更新: 19 Jul 2022

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
完整详情

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
完整详情

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
完整详情

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)
完整详情

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
完整详情

治疗流程

初步治疗

signs of airway compromise

急症处理

acute bacterial sialadenitis (nonobstructive)

obstructive sialadenitis

autoimmune sialadenitis

subacute necrotizing sialadenitis

持续性治疗

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Sialadenitis images
  • 鉴别诊断

    • Mumps
    • Sarcoidosis
    • Tuberculosis
    更多 鉴别诊断
  • 指南

    • Salivary gland disorders
    • Updated S2K AWMF guideline for the diagnosis and follow-up of obstructive sialadenitis - relevance for radiologic imaging
    更多 指南
  • 患者教育信息

    Measles, mumps, and rubella: should my child have the MMR vaccine?

    Rheumatoid arthritis

    更多 患者教育信息
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明