VERIFIED CONTENTAuthor: Dominika Wilk

An abscess, tumor or salivary stones are just some of the types of salivary gland diseases. They can be painful, make chewing difficult, and sometimes require complicated surgical procedures. Find out which symptoms most often accompany these diseases and how to recognize them in time.

Diseases of the salivary glands - characteristics and causes

Inflammation of the salivary glands

Inflammation of the salivary glands is the result of an attack by viruses or bacteria, or a consequence of other diseases that manifest themselves through the dysfunction of the salivary glands. It can affect only one salivary gland, e.g. submandibular, or attack all of them at once. Depending on how quickly and with what power the inflammatory process proceeds in the salivary glands. Inflammation can be divided into:

  • sharp,
  • chronic
  • or recurring.

Inflammation may have different causes. If there is widespread inflammation of the salivary gland (commonly known as "mumps"), it is caused by either a paramyxovirus or a cytomegalovirus. In turn, HIV and HCV viruses are behind chronic salivary gland inflammation.

Acute purulent inflammation is the result of bacteria and staphylococci such as, for example, Peptostreptococcus anaerobius or S. aureus.

Recurrent parotitis has an unknown etiology, it is suspected that it may be autoimmune or genetically determined. It is worth remembering that if all salivary glands are affected, it is rather a viral infection, and if it concerns a single gland - a bacterial one.

The symptoms of inflammation of the salivary glands vary depending on the type of inflammation. Mumps causes swelling of the salivary glands, sore throat, earache, malaise, loss of appetite.

In addition, there is pain when eating food, and sometimes trismus. All these symptoms may be accompanied by increased body temperature.

The symptoms of recurrent parotitis usually last for several days without fever. Then, swelling of the salivary gland and slight redness appear. Added to this is the emergence of cloudy discharge.

Purulent salivary gland inflammation will not go unnoticed, because it is accompanied by severe pain, strongredness of the salivary gland, swelling, and the discharge of purulent discharge. If inflammation develops in the parotid gland, you may experience a high temperature and a feeling of breakdown. There is also sometimes enlargement of the lymph nodes.

Diagnosis of inflammation of the salivary glands

The diagnosis of salivary gland inflammation differs depending on the disease entity. In the case of purulent inflammation of the salivary glands, it includes examination of the discharge from the mouth of the duct, as well as ultrasound.

In mumps, amylase is checked in the blood or in the urine, and 7-10 days after the onset of symptoms - specific IgM antibodies are tested. The diagnosis of recurrent salivary gland inflammation is primarily an interview and tests aimed at finding the real cause of the problem, e.g. whether it results from a weakened immune system or diabetes. In addition, ultrasound and MR are performed.

The consequences of untreated salivary stones are serious, as mechanical ducts may become obstructed, which will favor bacterial infections and the formation of abscesses. This disease can also paralyze the facial, sublingual or lingual nerves, the aforementioned fistulas, or slight facial deformities.

The main symptoms of the disease are: swelling of the glands and sharp pain caused by salivary colic (it occurs when chewing food) and the leakage of purulent contents (if urolithiasis is accompanied by a bacterial infection).

The diagnosis of urolithiasis is based on basic examinations such as: ultrasound of salivary glands, X-rays, as well as MRI, CT and sialography.

Salivary gland cancer

Salivary gland tumors appear most frequently in the parotid glands. The factor contributing to their development is infection with the Epstein-Barr virus (EBV) or the human papillomavirus (HPV).

Ionizing radiation also influences the development of benign and malignant neoplasms in this area. Salivary gland tumors can come from the parenchyma itself, develop inside the salivary gland capsule, or come from the tissues that surround the salivary glands.

Among salivary gland tumors we can distinguish benign tumors such as:

  • mixed tumor,
  • monomorphic adenoma,
  • hemangioma,
  • lymphatic adenocarcinoma,
  • oncocytoma,
  • sheath neuroma.

In turn, malignant tumors include:

  • mucocutaneous carcinoma,
  • adenocarcinoma,
  • adenocystic carcinoma,
  • light cell carcinoma,
  • squamous cell carcinoma,
  • malignant mixed tumor,
  • undifferentiated cancer.

Benign tumors of the salivary glands, if they develop slowly and over the years,may not show any characteristic symptoms at first. Only after some time there is a bulging in the projection of the salivary gland or the asymmetry of the face. There is also a lump that can be felt while washing the face or shaving.

In the case of malignant tumors, with an acute course, the facial nerve may be paralyzed, lymph nodes suddenly enlarged, or pain may be felt, e.g. caused by saliva stasis. Some cancers can also cause swallowing disorders.

The diagnosis of salivary gland tumors involves ultrasound, computed tomography and magnetic resonance imaging. In addition, ultrasound-guided fine-needle biopsy is also important, as it allows to assess the degree of tumor malignancy.

Diseases of the salivary glands caused by autoimmune diseases

As a consequence of some autoimmune diseases, the functioning of the salivary glands is disturbed. This is the case, for example, in Sjorgen's syndrome, which is a chronic, systemic and autoimmune disease involving the destruction of endocrine glands - primarily the lacrimal and salivary glands.

This disease leads to gradual eye dryness, irritation, conjunctivitis and corneal ulceration, and in the case of the salivary glands to a gradual reduction in salivation, which is accompanied by e.g. excessive dry mouth.

In the course of this disease, the salivary glands are enlarged, especially in the parotid, but the patient does not feel any pain. To conclude that we are dealing with a disturbance in the functioning of the salivary glands due to Sjorgen's syndrome, an ultrasound of the salivary glands with a biopsy should be performed, and also tests for specific ANA antibodies.

Treatment of diseases of the salivary glands

Each disease of the salivary glands requires consultation with an otolaryngologist. But the quickest consultation is needed in acute inflammation accompanied by an abscess where antibiotic treatment is required.

In recurrent inflammation of the salivary glands, treatment is limited to administering painkillers, taking care of oral hygiene, massaging the salivary glands to stimulate salivary secretion. Only in the case of exacerbations of inflammation, an antibiotic is given. For mumps, treatment is usually symptomatic, including the administration of painkillers or antipyretics and staying hydrated.

With salivary stones, the choice of treatment method depends on the size of the stone and its location. When we are dealing with a small stone, conservative treatment can be applied - flushing the salivary gland duct with chlorhexidine solution. In addition, the patient is introduced to a dietaimed at stimulating the production of saliva, as well as giving agents that increase its amount.

Sometimes this is how you can rinse out the stone by itself. When the symptoms in the form of pain are significant, also antispasmodics and anti-inflammatory drugs are administered, but then a surgical procedure consisting in removing stones from the duct is considered. Laser radiation may also be helpful in the treatment of small diameter stones.

Treatment of a cancer of the salivary glands always involves surgical removal of the tumor. However, in the case of malignant tumors, they are excised with a greater margin and the surrounding lymph nodes are removed. The treatment is complemented by radiotherapy.

Treatment of salivary discharge disorders caused by Sjorgen's syndrome is always conservative. Preparations that increase salivation are used, it is recommended to chew gum and ensure an adequate level of hydration. In addition, the patient must take extraordinary care of the oral cavity hygiene.

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