Otorhinolaryngology · MU Plovdiv

13. Diseases of the Salivary glands.Anatomy, Clinical Examination, Imaging Studies, and Biopsy of the Salivary Glands. Noninflammatory and Inflammatory Diseases. Sjogren Syndrome. Tumors of the Salivary Glands.

Inside: 11 sections · 12 labelled pictures · 3 tables · 16 flashcards · 12 min

Topic 13 of 18 in the MU Plovdiv syllabus for Otorhinolaryngology (Medicine, Year 4). The free AceMed note covers it in 11 sections, about 1,778 words (12 min of reading), with 16 flashcards.

In this note

  1. Diseases of the Salivary glands. Anatomy, Clinical Examination, Imaging Studies, and Biopsy of the Salivary Glands. Noninflammatory and Inflammatory Diseases. Sjogren Syndrome. Tumors of the Salivary Glands.
  2. Anatomy of Salivary Glands
  3. Physiology/ Function of Salivary Glands:
  4. Functions of saliva:
  5. Methods of Examination of Salivary glands
  6. Non-Inflammatory Diseases
  7. Inflammatory Diseases of Salivary Glands
  8. IV. Chronic Sclerosing Sialadenitis most common form
  9. V. Sjögren Syndrome – sicca syndrome
  10. VI. Mikulitz Disease - Considered a subtype of Sjogren’s syndrome (SS) due to histological similarity
  11. Tumors of Salivary Glands

Anatomy of Salivary Glands

  • Glands that secrete saliva 500ml -1000ml a day through duct

Major- (3)

  1. Parotid- Serous (Amylase only Produced)
  2. Submandibular – Mucoserous
  3. Sublingual – Mucoserous (Amylase & Mucin Produced)

Minor – Submucous

  1. Labial
  2. Lingual
  3. Palatal
  4. Pharyngeal
  5. Nasal

Not visible- if swollen → Retention cyst / tumor suspicion

Mainly Mucin Produced

1) Parotid gland 20 % saliva production – stimulated secretion

  • Largest salivary gland
  • Serous type -Rich in salivary amylase
  • Descends into retromandibular fossa between Mandible & Mastoid
  • In contact with SCM and posterior belly of digastric muscles
  • Embedded in a subcutaneous pseudocapsule.

Parotid duct (Stenson’s duct): 6cm

  • Excretory duct that leaves parotid gland → passes over and around masseter muscle → pierces buccinator muscle and buccal mucosa → opens opposite 2nd upper molar (5th teeth)

Blood supply: Superificial temporal & Maxillary branches of ECA

Innervation: Facial (CN VII)- Lateral & Deep lobe (Buccal, zygomatic, temporal, cervical branch)

Lymphatic drainage: intraglandular, periglandular, submandibular, deep neck

2) Submandibular gland 70 % saliva production – Resting secretion

  • SerousMucous type -Contains both Amylase & Mycin
  • Lies in submandibular trigone between mandible and digastric muscle.
  • Makes a U-shaped bend around mylohyoid muscle.
  • Connects to the sublingual gland and posterior oral floor.

Submandibular duct (Warton’s duct) 5cm

  • Excretory duct passes to sublingual plane of oral floor→ crosses over lingual nerve and opens at sublingual caruncle.

Blood supply: Facial artery & Vein

Innervation: Lingual & Hypoglossal

Lymphatic drainage: lateral and posteroinferior portion of gland which also receive drainage from face and oral cavity, so gland is removed in neck dissection.

3) Sublingual gland 5 % saliva production

  • SerousMucous type -But produced mainly mucin
  • Lies in anterior submucosal part of oral floor lateral to submandibular duct
  • Distributes along medial surface of Mandible

Multiple ducts: Known as Rivinus ducts (8-20 ducts)

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