Cysts of the parotid gland.
Simple cysts of the parotid gland are uncommon, and they have only rarely been reported. Two cases are reported here. The aetiology and management of parotid cysts is discussed.
Adult↗
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Cysts of the parotid gland. Review and report of two unusual cases.
Cysts of the major salivary glands are most frequent in the parotid where they form a small percentage of its benign tumours. They can be congenital or acquired and of parotid or extraparotid origin. Two unusual cysts are reported: a cholesteatoma arising from the ipsilateral mastoid, twenty years after successful radical mastoidectomy, and a deeply located cysts of probably congenital origin. The literature is reviewed and the management discussed. Parotidectomy, often with extensive dissection, remains in general the treatment of choice.
Cholesteatoma↗
A severe form of Sjogren's syndrome.
Sjogren's syndrome is an autoimmune disease characterized by exocrine gland destruction and manifested by parotid, submandibular and lacrimal gland infection. We report a case with recurrent severe parotid gland infections. The sialographic and CT findings are presented.
Autoimmune Diseases↗
Computerized tomographic and ultrasonographic features of Kimura's disease.
Kimura's disease (KD) is an uncommon condition once thought to affect only Orientals. The patients present with swelling of the major salivary glands associated with cervical lymphadenopathy. The clinical, histopathological and radiological findings of a young Caucasian female with KD will be presented and discussed.
Adult↗
Recurring bilateral parotid gland swelling: two cases of sialodochitis fibrinosa.
Salivary gland swelling is a commonly encountered clinical symptom, but the establishment of a diagnosis is occasionally difficult. Here, we present two sialodochitis fibrinosa patients with recurring bilateral parotid swelling. In both patients, secretion of mucous plugs containing numerous eosinophils was observed from Stensen's ducts. As expected, the level of interleukin-5 in the saliva was much higher than that in the serum. One patient had no medical history of allergic disease; the other had allergic rhinitis which had never been associated with parotid gland swelling. Microbiological examination was unable to isolate significant bacterial specimens from the mucous plugs. Thus, although allergy and/or bacterial infection are reportedly implicated as causes of sialodochitis fibrinosa, there may exist other possibilities for its pathogenesis. Interleukin-5 seems to play a crucial role in the pathogenesis of sialodochitis fibrinosa.
Eosinophilia↗
Bilateral aplasia of parotid glands correlated with accessory parotid tissue.
Congenital absence of major salivary glands, especially the parotid gland, is a rare entity. It is usually monolateral and is not correlated with accessory salivary gland tissue. Aplasia of parotid gland may occur alone or in association with abnormalities of other salivary glands, first branchial arch developmental disturbances or other congenital anomalies.We report an interesting case of bilateral aplasia of the parotid glands together with bilateral accessory parotid tissue, without other congenital or developmental anomalies, and we describe the clinical and radiological findings.
Adult↗
Salivary gland function in Sjögren's syndrome: a review.
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Biopsy↗
Diagnostic pitfalls. The pre-auricular swelling.
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Adenoma, Pleomorphic↗
Scintigraphic study of the major salivary glands in pediatric bone marrow transplant recipients.
Total body irradiation (TBI) at bone marrow transplantation (BMT) is shown to cause salivary gland dysfunction in children. The aim of the investigation was to study the function of major salivary glands in long-term surviving children following treatment with TBI, using salivary gland scintigraphy (SGS). Thirteen patients (seven male, six female), who had received TBI before the age of 13 years and survived more than 4 years, participated in the study. A reference group of 10 patients (nine male, one female) was examined shortly before they were to undergo BMT. The mean age was 14.1 +/- 4.1 years in the TBI-treated group and 12.8 +/- 5.9 years in the reference group. Unstimulated and stimulated whole salivary secretion rates were measured for 15 and 5 min, respectively, before SGS was performed. The percentage of stimulated secretion was 44.7 +/- 18.1% in the TBI-treated group compared to 58.4 +/- 13.0% in the reference group (P = 0.0438). Slower reaccumulation after excretion was found in the TBI-treated patients compared to the reference group (P = 0. 0300). The function of the major salivary glands in long-term survivors treated with TBI at BMT before the age of 13 years was found to be diminished, as shown by the reduced trapping rate and reduced emptying capacity, compared to prior to BMT. Bone Marrow Transplantation (2000) 26, 775-779.
Adolescent↗
Intra-oral ultrasound imaging of a submandibular duct calculus.
A case is presented showing the first reported use of a small, digitally-guided, intra-oral ultrasound probe to image a calculus in a submandibular salivary duct. This use of intra-oral ultrasound is discussed in the context of the overall current status of intra-oral and extra-oral ultrasound imaging. It is proposed that using a combination of intra-oral and extra-oral probes, the whole of the salivary apparatus may now be examined sonographically for the presence of calculi.
Adult↗
Sialographic characterization of the normal parotid gland of the miniature pig.
OBJECTIVE: To characterize the structure of the parotid gland of the miniature pigs (minipig). METHODS: Sialographic, anatomical, histological and ultrastructural studies of the parotid gland were performed on 11 minipigs. RESULTS: Sialograms showed a long main duct and a triangular shaped gland. All branching ducts extended from the inferior-posterior margin of the main duct. No accessory glands were found. Typical serous acini were found microscopically and histochemically. CONCLUSION: This study provides basic structural information on the parotid gland of the minipig.
Animals↗
The value of magnetic resonance imaging in a fistula of Wharton's duct.
A 30-year-old woman developed a fistula of the Wharton's duct following excision of the submandibular gland. The contribution of conventional fistulography, MRI and MRI fistulography in detecting the exact extent of the fistula is discussed.
Adult↗
The genu of the submandibular duct--is the angle significant in salivary gland disease?
OBJECTIVES: To investigate whether the angle of the genu of the submandibular duct is a significant contributory factor in the development of salivary calculi or sialoadenitis. METHODS: A preliminary test with a phantom was performed, taking oblique lateral views with different vertical and horizontal beam angulations to assess the effect on the genu angle. The phantom comprised a dried mandible and a piece of wire bent to simulate the submandibular duct. There were no differences in the measured angle of the bend in the wire within the range of beam angulations used in the clinical study. One hundred and two sialographs were analysed from three separate groups of patients, normal controls (n=18), proven salivary calculi (n=61) and those with sialoadenitis (n=23). The oblique lateral radiographs were digitised and imported into the Denoptix digital system, and the angle measured using the VixWin 2000 software. Differences in angle between groups were investigated using analysis of variance. RESULTS: The mean angle of the genu was 103 degrees (range 41 degrees-147 degrees) in the control group, 108 degrees (range 46 degrees-178 degrees) salivary calculi group, and 91 degrees (range 24 degrees-155 degrees) in sialoadenitis patients. There were no statistical differences in the angle between the groups. CONCLUSIONS: There is a wide variation in the angle of the genu of the submandibular duct (24 degrees -178 degrees ). This angle does not appear to be associated with either sialolithiasis or sialoadenitis.
Adolescent↗
Relation of preoperative sialographic findings with histopathological diagnosis in cases of obstructive sialadenitis of the parotid and submandibular glands: retrospective study.
The clinical records, preoperative sialograms and histopathological slides of 33 patients who had been operated on for symptoms of obstructive salivary gland disease were reviewed. Twenty patients had had superficial parotidectomy and 13 excision of the submandibular gland. Among those who had required parotidectomy, preoperative sialograms tended to suggest more architectural damage than was actually noted on definitive histopathological examination. Patients whose symptoms had been present for longer had more severe sialographic and histopathological changes. In the submandibular group, there was a closer relation between sialographic and histopathological changes, and a positive correlation between a short history and the severity of histopathological grading. These differences may reflect the different aetiology and course of obstructive disease in the two types of gland.
Adult↗
A multifocal neurinoma of the hypoglossal nerve with motor paralysis confirmed by electromyography.
A rare case of neurinoma in a 72 year-old Japanese woman derived from the hypoglossal nerve is reported. The tumour was composed of three interconnected nodules occurring simultaneously in the left submandibular and sublingual regions. The lesion, which presented as a neck mass, caused a slight left-sided hemiparesis of the tongue with tongue deviation to the affected side not noticed by the patient. An electromyographic (EMG) study revealed decreased muscle activity on the left side of the tongue muscle, indicating dysfunction of the hypoglossal nerve. EMG was useful for diagnosis.
Aged↗
Parotid neoplasms in children: experience of diagnosis and management in a district general hospital.
Parotid neoplasms are uncommon in children and the available literature is predominantly from specialized centres. This paper highlights our experience at a district general hospital, in the diagnosis and management of parotid neoplasms in children. The case records of all parotidectomies performed in a 26-year period between 1974-1999 were scrutinized and patients aged 18 years and below identified. The demographic data, histology, presentation, investigations, treatment, outcomes and complications were analysed. 545 parotidectomies were performed in 536 patients, in whom 569 neoplasms were diagnosed. Only 12 patients aged 18 and under were identified (2.2%). The relative frequency of individual tumours differed markedly from that in adults. 75% of the tumours were benign. Pleomorphic adenoma and mucoepidermoid carcinoma were the most common tumours. A painless mass was the most frequent clinical presentation and CT sialogram was the most common investigation. Parotidectomy with preservation of the facial nerve was performed in all cases, and adjuvant radiotherapy employed in the case of malignant tumours. All patients were alive and well at the time of last follow up. Transient facial nerve palsy and hypertrophic scars were the most common complications.
Adenoma, Pleomorphic↗