Head And Neck

Swellings In Parotid RegionAcute: SC tissue abcess Parotid Mumps, septic parotitis Bone OstemyelitisChronic: Salivary Gland origin Extrasalivary Gland origin

Salivary Gland originUnilateral (suspect Tumor): Cystic Adenolymphoma Solid Tumor (B or M)Bilateral (mostly Benign): Inflammatory (chronic Parotitis) Sialactaisis Endemic (Nutrirional) parotitis Mikulicz Syndrome,Sjogrens Tumor (10% Adenolymphoma) Others

Extra-salivary GlandSkin SubcutaneousLymph NodeFacial Nerve NeuromaMasseter Muscle Idiopathic Hypertrophy, FibrosarcomaMandibule Adamantimoma

Acute parotitis (Parotid Abscess)Aetiology: Organism: Staphaureus Route: mouth rare Blood Predisposed: Dehydration,Bad hygieneClinical Picture General: Toxaemia Local: Swelling, oedema, Throbbing pain, Tender gland, oral cavity pus on pressure on the gland, Cervical LNTreatment Incision and Drainage

Acute parotitis (Parotid Abscess)

Chronic Parotitis (Recurrent Parotitis)Adulthood: Obstruction by stone or stenosis Autoimmune (Bilateral) Sjogrens Syndrme Childhood (Sialectasis): Congenital Autoimmune ( 3m-10y )remit at 15y

Chronic Parotitis due to obstruction by stone

Chronic Parotitis due to Sjogrens SyndromeKeratoconjuntivitis SiccaXerostomiaRhematoid Arthritis

Cavitary sialectasis with Sjogrens Syndrome

Mikulicz syndrome

Sialectasis (snow storm apperance in sialogram)

Salivary Gland Calculi50 times more common in submandibular gland !Clinically recurrent inflammation,pain increase with meals,stone may felt in mouth floorDiagnosis : Plain x ray or Sialogram

Submandibular stone

Submandibular stone

Parotid stone

Treatment of salivary Gland CalculiParotid Gland single direct extraction multiple superficial parotidectomy Duct extraction in front of masseter transoral over the masseter parotid incisionSubmandibular Gland Excision Duct stone extraction from mouth

Submandibular excision