//fpnotebook.com/
Chronic Sialoadenitis
Aka: Chronic Sialoadenitis, Chronic Sialadenitis, Recurrent Parotitis, Chronic Bacterial Sialadenitis, Chronic Bacterial Parotitis, Chronic Suppurative Sialadenitis
- See Also
- Sialadenitis
- Recurrent Parotitis of Childhood
- Acute Nonsuppurative Sialoadenitis (Viral)
- Acute Suppurative Sialoadenitis (Bacterial)
- Sialolithiasis
- Salivary Gland Tumor
- Pathophysiology
- Repeated episodes of Salivary Gland (typically Parotid Gland) pain and inflammation
- Secondary to Sialolithiasis (due to stone, stricture, scarring or external compression)
- Salivary Gland stasis and acini replaced with cysts
- Chronic, low-grade Salivary gland Bacterial Infection
- Staphylococcus aureus
- Mixed Bacterial Infection
- Ultimately results in Salivary Gland destruction
- Progressive Salivary acini destruction and fibrosis
- Sialectasis
- Symptoms
- Recurrent Parotitis
- Mild Salivary Gland swelling and tenderness provoked with eating
- Signs
- Salivary Gland prominent and firm initially and later small and atrophic
- No Saliva typically expressed on Salivary Gland massage
- Differential Diagnosis
- Sjogren Syndrome
- Sarcoidosis
- Lymphadenopathy of the Head and Neck
- Sialolithiasis
- Recurrent Parotitis of Childhood
- Imaging
- Evaluate for Sialolithiasis (intraductal stone or stenosis, or external compression)
- Modalities
- Sialogram
- Computed Tomography (CT)
- Sialendoscopy
- Management
- Exclude obstruction (see imaging above)
- Treat Sialolithiasis if present
- Conservative therapy for non-obstructive cases
- Hydration
- Lemon drops and other sialagogues
- Salivary Gland massage
- NSAIDs
- Antibiotics
- Consider if suspected Bacterial Sialoadenitis (e.g. Augmentin, Clindamycin)
- Salivary Gland resection (e.g. Parotidectomy)
- Indicated in refractory cases
- O'Brien (1993) Head Neck 15(5): 445-9 [PubMed]
- References
- Chow in Mandell (2000) Infectious Disease, p. 699-700
- Walner in Cummings (1998) Otolaryngology, p. 5-121
- Wilson (2014) Am Fam Physician 89(11): 882-8 [PubMed]