Otolaryngology Book


Chronic Sialoadenitis

Aka: Chronic Sialoadenitis, Chronic Sialadenitis, Recurrent Parotitis, Chronic Bacterial Sialadenitis, Chronic Bacterial Parotitis, Chronic Suppurative Sialadenitis
  1. See Also
    1. Sialadenitis
    2. Recurrent Parotitis of Childhood
    3. Acute Nonsuppurative Sialoadenitis (Viral)
    4. Acute Suppurative Sialoadenitis (Bacterial)
    5. Sialolithiasis
    6. Salivary Gland Tumor
  2. Pathophysiology
    1. Repeated episodes of Salivary Gland (typically Parotid Gland) pain and inflammation
      1. Secondary to Sialolithiasis (due to stone, stricture, scarring or external compression)
      2. Salivary Gland stasis and acini replaced with cysts
    2. Chronic, low-grade Salivary gland Bacterial Infection
      1. Staphylococcus aureus
      2. Mixed Bacterial Infection
    3. Ultimately results in Salivary Gland destruction
      1. Progressive Salivary acini destruction and fibrosis
      2. Sialectasis
  3. Symptoms
    1. Recurrent Parotitis
    2. Mild Salivary Gland swelling and tenderness provoked with eating
  4. Signs
    1. Salivary Gland prominent and firm initially and later small and atrophic
    2. Unlike acute Sialoadenitis, the region is not warm, and tenderness is minimal to mild
    3. No Saliva typically expressed on Salivary Gland massage
  5. Differential Diagnosis
    1. General
      1. Lymphadenopathy of the Head and Neck
      2. Sialolithiasis
    2. Parotid Gland
      1. Recurrent Parotitis of Childhood
      2. Sjogren Syndrome
      3. Sarcoidosis
      4. Fungal infections
      5. Mycobacterium species
      6. Diabetes Mellitus
      7. Cirrhosis
      8. Salivary Gland Neoplasm
      9. Medications (rare)
        1. L-aspariginase
        2. Clozapine
        3. Phenylbutazone
        4. Brooks (2012) Ann Pharmacother 46(12): 1688-99 [PubMed]
  6. Imaging
    1. Evaluate for Sialolithiasis (intraductal stone or stenosis, or external compression)
    2. Modalities
      1. Sialogram
      2. Computed Tomography (CT)
      3. Sialendoscopy
  7. Management
    1. Exclude obstruction (see imaging above)
      1. Treat Sialolithiasis if present
    2. Conservative therapy for non-obstructive cases
      1. Hydration
      2. Lemon drops and other sialagogues
      3. Salivary Gland massage
      4. NSAIDs
    3. Antibiotics
      1. Consider if suspected Bacterial Sialoadenitis (e.g. Augmentin, Clindamycin)
    4. Salivary Gland resection (e.g. Parotidectomy)
      1. Indicated in refractory cases
      2. O'Brien (1993) Head Neck 15(5): 445-9 [PubMed]
  8. References
    1. Chow in Mandell (2000) Infectious Disease, p. 699-700
    2. Walner in Cummings (1998) Otolaryngology, p. 5-121
    3. Wilson (2014) Am Fam Physician 89(11): 882-8 [PubMed]

Chronic sialadenitis (C0341052)

Concepts Disease or Syndrome (T047)
SnomedCT 235126009
English Chronic nonspecif sialadenitis, Chronic sialadenitis, Chronic nonspecific sialadenitis, Chronic sialadenitis (disorder)
Spanish sialoadenitis crónica (trastorno), sialoadenitis crónica
Derived from the NIH UMLS (Unified Medical Language System)

Recurrent parotitis (C0399580)

Concepts Disease or Syndrome (T047)
SnomedCT 235125008
English recurrent parotitis, Recurrent parotitis, Recurrent parotitis (disorder)
Spanish parotitis recurrente (trastorno), parotitis recurrente
Derived from the NIH UMLS (Unified Medical Language System)

chronic sialoadenitis (C2887627)

Concepts Disease or Syndrome (T047)
ICD10 K11.23
English Chronic sialoadenitis, chronic sialoadenitis (diagnosis), chronic sialoadenitis, sialoadenitis chronic
Derived from the NIH UMLS (Unified Medical Language System)

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