Salivary Glands Diseases

Dr. Brakat mokhtar

 Anatomy
• Major salivary glands : parotid,
submandibular, sublingual
• Minor salivary glands: located throughout
the upper airway, with concentration in the
oral cavity.
 Parotid gland
• Anterior: masseter muscle
• Posterior : tragal cartilage and
sternocleidomastoid M
• Superior: zygomtic arch
• Had superficial and deep lobes, divided by the
facial N
• The deep lobe is in the prestyloid compartment
of parapharyngeal space
• Stensen duct: transverse the masseter M and
opens in oral cavity opposite to 2nd upper molar
• The parotid fascia : continuation of the
superficial layer of deep cervical fascia and is
divided into superficial and deep layers
• The superficial fascia is dense,extends from the
masseter anteriorly and the sternocleidomastoid
posteriorly, and extends superiorly to the
zygoma. It sends septa into the glandular tissue,
which prevents separation of a surgical plane
between the gland and its fascia
• Because of the presence of this inelastic
capsule, inflammatory conditions of the gland
tends to be very painful.
• The deep layer of parotid fascia extends from
the fascia of the posterior portion of the digastric
muscle and forms the stylomandibular
membrane.
• The membrane separates the parotid gland
from the submandibular gland
• The parotid gland is the only salivary gland with
two layers of nodes. The superficial layer,
consisting of approximately 3 to 20 nodes, lies
between the gland and its capsule.
• The second layer of nodes lies deep in parotid
tissue
 Submandibular gland
• Superior : mandible
• Inferior : the 2 bellies of digastric M
• The gland lies medial and inferior to the
mandibular ramus and wraps around the
mylohyoid muscle in a C-shaped fashion to
produce a superficial and deep lobe
• The superficial lobe lies in the lateral sublingual
space.
• The deep lobe of the gland lies inferior to the
mylohyoid muscle and constitutes the bulk of the
gland.
• Wharton duct : opens in the floor of the mouth
and it courses deep to the lingual N
 Sublingual gland
• Located opposite to the lingual frenulum,
superior to the mylohyoid M
• Drains either independently via Rivinus
duct or via submandibular duct via
Bartholin duct
 Physiology
• The basic unit of the salivary gland consists of
an acinus, a secretory duct, and a collecting
duct
• Acini are classified as serous, mucous, or mixed
• Parotid scretion is serous, subandibular is mixed
and sublingual is mucous.
• During rest , the production of saliva is mainly by
the submandibular gland , where in stimulated
condition it is maily by the parotid
• Saliva is composed of water 99%, organic and
organic substances.
• There are five major functions of saliva:
(1) lubricating the food bolus and lavaging the oral
cavity surfaces with a biofilm barrier
(2) providing buffering capacity
(3) maintaining tooth integrity
(4) performing antibacterial functions
(5) aiding taste and digestion