The first of the salivary glands is the PAROTIS gland in front of the ear, located in the lateral part of the face. The lower parotid tail is located between the corner of the lower jaw and the SCM muscle. The parotid superficial and deep lobes are separated by the facial nerve. It opens into the oral mucosa through the Stenson canal at the level of the upper second molar tooth. When the facial nerve enters the parotid gland, it branches and provides innervation to one side of the face.
The second of the salivary glands is the SUBMANDIBULAR gland. They are located bilaterally under the chin. They open to the middle of the floor of the mouth through the Wharton canal.
The last of the salivary glands are the SUBLINGUAL and MINOR salivary glands. Sublingual glands are a pair. They are located on both sides of the lingual frenilum and open to the floor of the mouth or are opened by connecting the duct of the submandibular gland to the Bartholin duct. Mucoceles of the sublingual glands are called RANULA.
Minor salivary glands are located in the upper respiratory tract, concentrated in the oral cavity and can be found in 600 - 1000 pieces.
IMAGING
Magnetic resonance; In addition to MRI, PET (positron emission tomography) and needle aspiration biopsy (IAB) can be used as a complement in the postoperative period or in the follow-up of recurrent tumors after chemotherapy and radiotherapy treatment. Nuclear scintigraphy; It is useful in the diagnosis of WARTHIN tumor and oncocytoma.
Ultrasound; Color Doppler ultrasound can predict malignancy by detecting increased vascularity.
SIALOADENITIS
Acute Inflammatory Sialoadenitis
The elderly, the debilitated and In post-operative patients, the parotid gland is most commonly affected. Unilateral swelling and inflammation from the STENSON duct are typically observed in the parotid. Stone or abscess is seen on CT. Its treatment is possible with antibiotics.
Chronic Sialoadenitis
It causes stenosis of the STENSON duct and the secretory functions of the gland decrease. If it does not respond to antibiotic treatment, surgical complete sialoadenoidectomy may be required.
Sialolithiasis
Salivary calculus (sialolith) begins with a secretory disorder. As the secretory material in the lumen becomes denser, calcification increases, obstruction and inflammation occur. Infection due to decreased secretory activity as a result of atrophy lamation becomes chronic and, as a result, sialolith develops. Salivary calculus imaging can be done with plain radiography, sialography, ultrasound, CT and scintigraphy.
Sialoendoscopy
It may be useful in finding the cause of salivary gland swelling and in diagnosis. Thus, reasons that are not very obvious can be identified. 1.3 mm endoscopes can be used.
TUMORS AND CYSTS OF SALIVARY GLANDS
Benign Tumors
Mixed tumors; It is the most common salivary gland tumor.
Myoepithelioma; It constitutes 1% of the salivary gland.
Warthin tumor; It is the 2nd most common benign tumor of the parotid.
Basal cell adenoma; It occurs in older ages.
Canalicular adenoma; It is usually a slowly growing mass on the upper lip.
Oncocytoma; It is 1% of salivary gland tumors.
Lipoma ;
Acquired salivary gland cysts
Sialoadenosis; is the symmetrical growth of the salivary glands.
Malignant Tumors
Mucoepidermoid carcinoma; It is the most common malignant tumor.
Adenoid cystic carcinoma; It constitutes 10% of malignant salivary glands.
Acinic cell carcinoma; Treatment is excision with good surgical margins.
Epiterial – Myoepithelial carcinoma;
Salivary duct cancer;
Terminal duct adeno cancer ;
Adeno cancer
Ex – Pleaomorphic adenoma; It is the most common malignant mixed tumor. It develops from a long-existing mixed tumor.
Lymphoma; Parotid is the most commonly involved tumor. Primary lymphoma develops from lymphocytes within the parotid.
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