Salivary Gland Disorders

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1 Salivary Gland Disorders Introduction Located in your mouth and throat, the salivary glands make saliva. Saliva is the watery fluid in the mouth. There are many problems that can affect the salivary glands. Treatment for salivary gland disorders depends on the cause. Treatment may include home remedies, antibiotics, surgery, or other treatments. The Salivary Glands This reference summary explains common salivary gland disorders. It discusses symptoms, diagnosis, and treatment of these disorders. The Mouth and Throat There are many structures that make up the mouth and throat. The mouth, or oral cavity, includes: Lips Gums and teeth Tongue Lining of your cheeks The oral cavity also includes the floor and roof of your mouth. The floor of your mouth is the area under the tongue. The roof of the mouth is made up of the hard and soft palates. The hard palate is the front, bony part of the roof of your mouth. Behind the hard palate is the soft palate. The soft palate is the back, muscular part of the roof of the mouth. The uvula is a soft flap of tissue that hangs down at the back of the mouth. 1

2 Another part of the mouth and throat is the salivary glands. The salivary glands make saliva. Saliva is the watery fluid in the mouth. It is also called spit. Saliva moistens food to help digestion. It also protects the mouth against infection. There are 3 major pairs of salivary glands: Parotid glands, which are the largest and are found in front of and just below each ear Sublingual glands, which are found under the tongue in the floor of the mouth Submandibular glands, which are found below the jawbone There are also hundreds of smaller salivary glands lining parts of the mouth, such as your lips and cheeks. Smaller salivary glands may also be found in the nose and larynx. The larynx is also known as the voice box. It is the area of the throat containing vocal cords and used in breathing, swallowing, and talking. Small tubes called ducts are located in the mouth. Saliva made by the salivary glands drains into the mouth through these ducts. Symptoms Many salivary gland disorders have similar symptoms. The main symptom of salivary gland disorders is irritated or swollen salivary glands. Other common symptoms of salivary gland disorders include: Bad taste in the mouth Difficulty opening your mouth Dry mouth Pain in the face or mouth Swelling of the face or neck Some salivary gland disorders may also be associated with the following symptoms: Dry eyes Loss of facial movement Pain while eating Tender lump in the mouth or throat 2

3 If you notice any of these symptoms or other changes, talk to your healthcare provider. Finding a problem early makes treatment easier in most cases. Infection One of the most common salivary gland problems is infection. In children, the most common salivary gland infection is mumps. Mumps is a contagious disease caused by the mumps virus. Mumps typically starts with a few days of fever, headache, muscle aches, tiredness, and loss of appetite. Then the parotid salivary glands swell. These glands are located between your ear and jaw. When these glands swell, it is often called chipmunk cheeks because of the appearance it causes. Anyone who is not immune from either previous mumps infection or from vaccination can get mumps. However, routine vaccination has made mumps much less common. Mumps usually goes away on its own within 2 weeks. Because it is a viral infection, antibiotics cannot treat mumps. You can help relieve the symptoms of mumps by: Drinking lots of fluids to prevent dehydration. Getting plenty of rest. Taking over-the-counter pain relievers. Children should not take aspirin to treat fevers as this can cause a potentially deadly condition known as Reye s syndrome. Other types of infections can also affect the salivary glands. For example, infections that start in nearby lymph nodes can spread to the salivary glands. Bacterial infection of the salivary gland is called sialadenitis. It is more common in older adults, but it can also affect babies in the first few weeks of life. If left untreated, sialadenitis causes high fever and a painful lump that fills with pus. Antibiotics may be used to treat infections caused by bacteria. Other treatments for these types of infections may include: Drinking lots of fluids Eating sour, sugarless candy to encourage the production of saliva Warm compresses to the infected gland 3

4 Infection may also be a sign of an obstruction or tumor in the salivary glands. In these cases, the obstruction or tumor must be removed to treat the infection. Obstruction Obstruction of the salivary glands or ducts may be caused by salivary stones, cysts, or tumors. The blockage can cause the salivary glands to become swollen. Salivary stones are the most common cause of swollen salivary glands. They are made from saliva deposits that crystallize and harden into stones, blocking the salivary ducts. Cysts can also cause obstruction and prevent saliva from flowing freely. Some babies may be born with cysts in the parotid glands. This is due to problems with the development of the ears. Rarely, obstruction may be caused by structural problems in the duct system of major salivary glands. The ducts may narrow, causing an obstruction. Obstruction of the salivary glands or ducts prevents the flow of saliva, resulting in pain and swelling. The pain and swelling will get worse over time if left untreated. Often the affected salivary gland also becomes infected. Symptoms of salivary gland obstruction usually appear or get worse when eating. This is because more saliva is produced to aid swallowing and digestion. Treatment for obstruction depends on the cause. Salivary stones near the duct may be removed by your doctor. Small cysts may drain on their own. Deeper stones, larger cysts, and tumors may require surgery. Cancer Problems with the salivary glands may also be caused by cancer. Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms new cells as you need them, replacing old cells that die. Sometimes this process goes wrong and a tumor forms. If a tumor is cancerous, cells from the tumor can invade other tissues throughout the body. Cancerous cells can spread to different parts of the body through blood vessels and lymph channels. 4

5 Cancers in the body are given names, depending on where the cancer started. Cancer that begins in the salivary glands will always be called salivary gland cancer, even if it has spread to other places in the body. Salivary gland cancer is rare. Most major salivary gland tumors begin in the parotid glands. Most small salivary gland tumors begin in the palate, or roof of the mouth. It is usually impossible to specify the cause of cancer in an individual patient. However, we do know what causes cancer in general. Doctors also know factors that can increase the chances of getting cancer. These are known as risk factors. Risks factors for salivary gland cancer include: Age, as it is more common in older adults Exposure to radiation Exposure to certain substances in the workplace, especially jobs in plumbing, rubber manufacturing, or working around asbestos Treatment for salivary gland cancer may include surgery, radiation therapy, chemotherapy, or some combination of these treatments. Radiation therapy uses high-energy rays to kill cancer cells and stop them from growing and spreading. Chemotherapy is the use of drugs to kill cancer cells. Other Disorders Sometimes problems with the salivary glands are due to other disorders. For example, the salivary glands are often affected in people with Sjogren s syndrome. Sjogren s syndrome is an autoimmune disease. An autoimmune disease means that the immune system, which is supposed to fight disease, mistakenly attacks parts of the body. In Sjogren s syndrome, the immune system attacks the glands that make tears and saliva. Sjogren s syndrome may also affect the joints, lungs, kidneys, blood vessels, digestive organs, and nerves. 5

6 The main symptoms of Sjogren s syndrome are dry eyes and a dry mouth. It can also lead to dryness in other places that need moisture, such as the nose, throat, and skin. Sometimes Sjogren s syndrome also causes the salivary glands to become enlarged. Treatment for Sjogren s syndrome focuses on relieving symptoms. Often different types of medicines are used to relieve dry eyes or dry mouth. Other disorders can also cause problems with the salivary glands. HIV is another disease that can cause the salivary glands to become enlarged. HIV spreads when infected blood, semen, or vaginal secretions enter the body. Medicines are available to fight HIV infection. The salivary glands may also become enlarged in people with diabetes. The parotid glands on the sides of the face are often affected. Alcoholism may also cause these glands to swell. Diagnosing Salivary Gland Disorders Doctors diagnose salivary gland disorders using different tests. This section explains the tests that may be used. Your healthcare provider will first ask about your symptoms and health history. A physical exam will be performed. Sometimes a lump or swollen salivary glands may be found during a physical exam. Laboratory tests such as blood or urine tests can help diagnose infection and rule out other possible causes of your symptoms. Dental x-rays and other imaging tests may be used to examine the salivary glands. Other imaging tests that may be done include an ultrasound, CT scan, or MRI. These tests can help detect an obstruction or blockage. An x-ray is a type of high-energy radiation that can go through the body and onto film, making a picture. An injection of dye may be given to make abnormal areas easier to see. An ultrasound uses sound waves. The echoes of the sound waves create a picture of the inside of the body. 6

7 A CT scan is an x-ray machine linked to a computer. A CT scan takes detailed pictures of your organs. An MRI uses strong magnets to create images of the inside of the body. If a mass is found, a biopsy may be needed to make a diagnosis. A fine needle aspiration biopsy uses a very thin needle to take a sample of the mass. A pathologist will examine the tissue sample under a microscope to look for abnormal cells. In most cases, a biopsy is the only sure way to tell if cancer is present. A lip biopsy of minor salivary glands may also be done. This can help diagnose certain autoimmune diseases, such as Sjogren s syndrome. Summary Located in your mouth and throat, the salivary glands make saliva. Saliva is the watery fluid in the mouth. There are many problems that can affect the salivary glands. Problems may include infection, obstruction, cancer, or other disorders. There are many tests that can be used to diagnose salivary gland disorders. These tests help determine the cause of salivary gland symptoms. Treatment for salivary gland disorders depends on the cause. Treatment may include home remedies, antibiotics, surgery, or other treatments. It may also include radiation therapy or chemotherapy if the cause is cancer. Talk to your healthcare provider if you notice any abnormal changes or salivary gland symptoms. Finding a problem makes its treatment easier in most cases. 7

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