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NECROTIZING SIALOMETAPLAS IA

Necrotizing sialometaplasia

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Page 1: Necrotizing sialometaplasia

NECROTIZING SIALOMETAPLASIA

Page 2: Necrotizing sialometaplasia

Necrotizing Sialometaplasia• Uncommon locally destructive

inflammatory condition of the salivary glands.• Cause: unknown but they believe it

is the result of ischemia of the salivary tissue that leads to local infaction.

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Saliv

ary

Glan

d tis

sueISCHEMIA

OXYGEN

No blood supply

No oxygen

No ATP

No glucose

IN

FA

RC

TI

ON

ISCHEMIA AND LOCAL INFARCTION LEADING TO NECROTIZING

SIALOMETAPLASIA

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Predisposing factors:

–Traumatic injuries –Dental injections–Ill fitting dentures–Upper respiratory

infections

–Adjacent tumors–Previous tumors

***However many cases occur without any known predisposing factors.

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CLINICAL FEATURES

• Most frequently develops in the palatal salivary glands• Hard palate > soft palate

***2/3 of palatal cases are unilateral, with the rest being bilateral or midline in location

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Unilateral

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Bilateral

Midlinein location

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CLINICAL FEATURES

• Has also been reported in other minor salivary gland sites and occasionally in the parotid gland.• Submandibular and sublingual

glands are rarely affected.

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CLINICAL FEATURES

• Most common in adults and in men• The condition appears initially as a

non-ulcerated swelling often associated with pain or paresthesia with crater-like ulcer that can range from less than 1cm to more than 5cm in diameter appearing within 2 to 3 weeks.

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CLINICAL FEATURES

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HISTOPATHOLOGIC FEATURES

• Microscopic appearance of necrotizing sialometaplasia is characterized by acinar necrosis in early lesions, followed by associated squamous metaplasia of the salivary ducts.

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HISTOPATHOLOGIC FEATURES

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Treatment

• The lesion is self-limiting in most instances and heals uneventfully.

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Xerostomia

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Xerostomia

• Refers to subjective sensation of a “dry mouth”• Frequently but not always

associated with salivary gland hypofunction.

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Xerostomia

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CAUSES

• DEVELOPMENTAL-Salivary gland aplasia

• WATER OR METABOLITE LOSS impaired fluid intake

-impaired fluid intake-hemorrhage-vomiting or diarrhea

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CAUSES

• IATROGENIC-medications

• LOCAL FACTORS-decreased mastication-smoking-mouth breathing

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CAUSES

• SYSTEMIC DISEASES-Sjogren’s syndrome-diabetes mellitus-diabetes insipidus-sarcoiadosis-HIV infection-Graft-versus-host disease-psychogenic disorder