SALIVARY GLAND

Salivary glands are exocrine glands

situated in relation to the oral cavity
and oropharynx that secret saliva.
 ANATOMY
There are 3 pairs of major salivary glands:
1. Parotid gland
2. Submandibular gland
3. Sublingual gland
 Minor Salivary gland
They are present scattered in the upper
aero-digestive tract. (e.g, lips, cheeks,
palate, floor of the mouth, retro molar
area etc.)
 PAROTID GLAND
This is the largest salivary gland.
The gland derives its name from para-
around and otic-ear, that is around the ear.
The gland is divided into a larger superficial
lobe and a smaller deep lobe by facial nerve
branches.
 PAROTID GLAND
The parotid duct (Stenson’s duct)
opens into the vestibule of oral cavity
adjacent to the 2nd upper molar tooth.
The secretion of parotid gland is serous
in nature.
SUBMANDIBULAR GLAND
Situated in submandibular region and
drains via submandibular duct
(Wharton’s duct) into the floor of the
mouth on each side of frenulum.
The secretion is mixed in nature.
 SUBLINGUAL GLAND
The sublingual gland lies on the floor of
the mouth and drain via number of
smaller ducts.
Secretion is predominantly mucous in
nature.
Function of Salivary Gland
1. Maintenance of oral and dental hygiene.
2. Lubrication of oral cavity and pharynx for
speech, mastication and swallowing.
3. Initiation of early phase carbohydrate
digestion by salivary amylase.
Diseases of Salivary Gland
It may be
Infective– viral, bacterial
Autoimmune
Neoplastic
 Mumps
It is a common infectious disease
occurring mainly in children. It
involves the parotid gland and
occasionally submandibular gland.
 Mumps

Causative agent: Paramyxovirus

Mode of transmission: By droplet and
fomites
 Mumps
Clinical features:
Pain and swelling over one or both
parotid region with fever and difficulty
in opening the mouth.
 Mumps
Treatment:
Bed rest
Plenty of fluid
Application of heat is soothing
Analgesic and anti-pyretic for pain and fever
Antibiotic: If there is a chance of secondary
bacterial infection.
Acute Suppurative Parotitis
It is most commonly seen in the elderly,
debilitated and dehydrated patients.
Dry mouth due to any cause is a
predisposing factor.
 Acute Suppurative Parotitis
Most common organism is Staphylococcus
aureus. Other gram positive and aenorobic
organism have also been observed.
Bacterial infection spread via the parotid
duct into the gland from the oral cavity.
 Acute Suppurative Parotitis
Clinical Features:
The onset is sudden with severe pain and
enlargement of gland. Movement of the jaw
aggravate the pain.
Opening of the duct is red, swollen and
there may be discharging pus.
 Acute Suppurative Parotitis
Treatment:
Antibiotic
Analgesic
Maintenance of good oral hygiene and adequate
hydration.
If abscess is formed then incision and drainage is to be
carried out.
 Salivary Calculi
80-90% cases seen in submandibular
gland. Because secretion is thick,
alkaline and passes against the gravity.
Stones are formed in the duct or
parenchyma of the gland.
 Salivary Calculi
Clinical Features:
Intermittent swelling of the involved gland.
Pain due to obstruction to outflow of saliva.
 Salivary Calculi
Investigation
80% stones are radio-opaque.
1. X ray occlusal dental view
2. Lateral X ray of submandibular region
Occlusal
dental view
X ray
 Salivary Calculi
Treatment:
Stone in the gland—excision of the gland.
Stone in the duct---remove intra-orally by
ductal incision
 Neoplasm of salivary glands

The tumours of salivary glands are either from

epithelial or mesenchymal tissues.
Larger the size of salivary gland, more are the
chance of a tumour being benign.
 Classification
Benign:
1. Epithelial- Pleomorphic adenoma,
Warthin tumour, Oncocytoma etc.
2. Mesenchymal- Haemangioma,
Lymphangioma, Lipoma, Neurofibroma
etc.
 Classification
Malignant:
1. Epithelial- Mucoepidermoid carcinoma,
Adenoid cystic carcinoma, Adenocarcinoma,
Acinic cell carcinoma, Malignant mixed
tumour, Squamous cell carcinoma etc.
2. Mesenchymal- Lymphoma, Sarcoma.
Frequency & Distribution
Type Location Frequency Malignant

Major Parotid Common 10-20%

Submandibular Uncommon 50%
Sublingual Very rare 85 %
Minor Upper Rare 90%
aerodigestive tract
 Neoplasm of salivary glands
Most common benign tumour is
pleomorphic adenoma.

Most common malignant tumour is

mucoepidermoid carcinoma
 Neoplasm of salivary glands

Rapid growth, restricted mobility, fixity of

overlying skin, pain and facial nerve
paralysis indicate the possibility of tumour
being malignant.
Parotid tumour
Neoplasm of salivary glands

Most of the salivary tumours present as a

painless swelling in the region of the gland.
 Rule of 80
80% of salivary tumours occur in the parotid
gland.
80% of parotid tumours occurs in superficial lobe.
80% of parotid tumours are benign.
80% of benign parotid tumours are pleomorphic
adenoma
 Treatment
Benign tumour and low grade malignant tumour:
In parotid gland: Superficial lobe- superficial
parotidectomy, deep lobe– Total conservative
parotidectomy.
In submandibular gland: Excision of
submandibular gland
 Treatment
High grade malignant tumour:

Radical excision of the gland