SIALADENITIS

K.ABHINAYA. BDS 3rd year

SIALADENITIS

 It is inflammation of the salivary gland.

 It mainly affects major salivary glands common in
parotid and submandibular gland.
 Sialadenitis can be acute and chronic.
 Acute is common in parotid usually due to
staphylococcus infection and mumps virus infection.
Acute sialadenitis of parotid

 It is a sudden onset of erythamatous swelling of pre/post auricular areas extend into

the angle of mandible.
 It is bilatetal in 20%.
Causes:
Bacterial-Staphlococcus aureus
Viral-mumps
Allergic
HIV Infection
Radiotherapy
Pathogenesis:
 Retrograde infection in reduced salivary flow
 Local abnormalities in gland architecture.
CLINICAL FEATURES:

 Pyrexia, malaise, pain and trismus.

 Red, tender, warm, well-localised, firm swelling is seen in
parotid region.
 Tender lymph nodes are palpable in neck.
 Features of bacteremia is present in severe cases.
 Pus or cloudy turbid saliva may be expressed from the
parotid duct probing .
 Dry mouth with chills.
Investigations:

 Ultrasound of parotid region.

 Pus collected from duct orifice is sent for culture and
sensitivity.
 Needle aspiration.
 WBC count-leucocytosis
 Sialogram is contrindicated in acute phase, as it causes
retrograde infection leading into bacteremia.
Management and treatment:

 Warm salt water rinse may be soothing and keep the

mouth moist.
 Massaging the gland with heat may helps
 HYDRATION-Drink lot of water and use sugar-free
lemon drops to increase the flow of saliva and
reduce swelling.
 Antibiotics are started depending on culture report.
 If there is abscess,surgery to drain or aspiration may be
done.
 BLAIR INCISION used to drain the abscess.
 severe cases(antibiotic+surgical intervention)
Complications

 Septicemia
 Severe trismus
 Rupture into external auditary canal.
 Abscess
 Cellulutis
 Ludwigs angina
 If there are attacks more than approximately 3 times
per year or severe attacks, surgical excision of the
affected gland should be considered.