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Submandibular gland excision: a five-year review.

Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. This retrospective study of 93 consecutive patients who underwent excision of the submandibular gland in the Department of Otolaryngology, Singapore General Hospital over a five-year period was undertaken to study the indications of surgery, the pathology of the excised submandibular gland and the demographic profile of patients. Fifty-six (60.2 per cent) patients underwent submandibular gland excision for non-neoplastic salivary gland disease while 37 (39.8 per cent) had neoplastic submandibular gland disorders. The commonest pathology encountered was sialadenitis/sialolithiasis (53.76 per cent) followed by pleomorphic adenoma (33.33 per cent). Fine needle aspiration cytology (FNAC) was a valuable pre-operative investigation with a sensitivity and specificity of 94.7 per cent and 100 per cent respectively for neoplastic disease. The morbidity rate for this surgery was 4.3 per cent.

Adenoma, Pleomorphic↗

[Xerostomia. Diagnosis and treatment].

Comprehensive examination and treatment were made of 57 patients with xerostomia on the background of different salivary glands diseases. Mexidol was used for treatment in the form of external blockade in the region of the salivary glands. Expressed clinical effect was observed in 67% of patients with considerable reduction or disappearance of oral cavity xerostomia, decrease of glands swelling and general condition improvement. Indices of lipid peroxidation and of antioxidant protection of mixed saliva of xerostomic patients differed from analogous control data and depended upon the type of xerostomia involved.

Adolescent↗

Lectin histochemistry of dog major and minor salivary glands.

The distribution of different carbohydrates in dog major and minor salivary glands was investigated using a peroxidase-labelled avidin-biotin method to demonstrate binding of six lectins (Canavalia ensiformis agglutinin [Con A], Dolichos biflorus agglutinin [DBA], Arachis hypogaea (peanut) agglutinin [PNA], Glycine max agglutinin [SBA], Tetragonolobus purpurea agglutinin [TGP] and wheat germ agglutinin [WGA]). With PNA, there was only weak staining in serous acini of parotid glands. Other lectins bound, to different degrees, to different components of the salivary glands; differences could be detected between glands and between binding of different lectins to serous and mucous acinar cells and to the epithelial cell cytoplasm, luminal surface and contents of ducts. These results provide a basis for the comparison of possible changes in carbohydrates which may occur in salivary gland diseases.

Animals↗

Epstein-Barr virus in the sublabial salivary gland in Sjögren's syndrome.

The proposed role of Epstein-Barr virus (EBV) in salivary gland destruction in Sjögren's syndrome (SS) prompted the authors to study the presence of EBV-DNA (hybridohistochemistry) and EBV-encoded proteins (immunohistochemistry) in sublabial salivary glands taken from eight patients with primary and five with secondary SS and from 16 controls. DNA probes and anti-EBV antibodies were controlled for activity by assessment of human blood B-lymphocytes after in vitro infection with EBV. None of the tissues investigated manifested the presence of EBV proteins (nuclear antigen, early antigen R, membrane antigen, or viral capsid antigen). The salivary gland biopsies of four patients with primary SS and two with secondary SS showed EBV-DNA in epithelial cells of acini and ducts but not in other components. The authors data contrast with those of Fox and colleagues (J Immunol 1986;137:3162-3168), who reported that about half of the patients with SS have EBV early antigen D in epithelium of the sublabial salivary gland. The authors conclude that an active EBV infection associated with EBV protein synthesis does not occur in the diseased salivary gland of patients with SS, but the presence of EBV-DNA in the glands does not exclude a possible role of EBV in the disorder.

DNA Probes↗

Mikulicz disease of a minor salivary gland.

The third recorded instance of Mikulicz disease of a minor salivary gland is described; this is the first case in which a surgical specimen, in addition to the biopsy specimen, was obtained for microscopic examination. A brief description of the disease and its treatment is also presented.

Aged↗

Anion exchanger immunoreactivity in human salivary glands in health and Sjögren's syndrome.

Salivary gland ducts play a relevant role in saliva secretion through transport processes. Na(+)-independent chloride-bicarbonate anion exchangers (AE) may be involved in these processes by generating ion fluxes into the salivary secretion. In Sjögren's syndrome, a disorder with gland dysfunction, there might be an impaired expression of AE proteins. Here we study AE immunoreactivities in human salivary glands, both in health and in Sjögren's syndrome. Immunohistochemistry was carried out on salivary glands from normal subjects and patients with Sjögren's syndrome, using two monoclonal antibodies against AE1 and AE2. Normal salivary glands showed AE2 immunoreactivity, which was restricted to the epithelium of the ducts, with no staining at the acini. A strong positivity was seen in the basolateral portion of the striated ducts, while interlobular duct cells showed a discrete positivity at their apical pole. In salivary glands from most of the patients with Sjögren's syndrome, AE2 immunoreactivity was absent in the ducts as well as in the acini. In both normal and diseased salivary glands, AE1 immunoreactivity was only located at the erythrocyte membrane. The recently reported AE0 was discarded because no AE0 message was found in salivary glands by reverse transcription polymerase chain reaction. In conclusion, AE2 immunoreactivity is observed in the ducts of normal salivary glands, particularly in the striated ducts. AE2 immunoreactivity is virtually absent in salivary glands from patients with Sjögren's syndrome, which may reflect either a loss of AE2 after inflammatory atrophy, or a primary defect occurring in the disease.

Adult↗

[The treatment of salivary cysts in dogs and cats].

The anatomy and physiology of the salivary glands in dogs and cats are briefly discussed. A salivary mucocele is due to leakage of saliva from the salivary gland or from its duct. Trauma is usually referred to as the underlying cause. Treatment of salivary mucoceles (cervical salivary gland cyst, ranula or pharyngeal mucocele) consists in surgical resection of the affected salivary gland.

Animals↗

Vascular endothelial growth factor (VEGF) and chronic graft-versus-host disease (cGVHD) in salivary glands of bone marrow transplant (BMT) recipients.

BACKGROUND: The purpose of this study was to compare the immunolocalization of vascular endothelial growth factor (VEGF) in salivary glands of bone marrow transplant (BMT) recipients with normal controls and between the different stages of chronic graft-versus-host disease (cGVHD). In addition, the impact of the immunolocalization of VEGF on the survival rate of BMT patients was investigated as well. METHODS: Labial salivary glands obtained at the day 100+ from 36 consecutive patients, who underwent BMT, were included in the study. The streptavidin-biotin-peroxidase complex stain was used to detect VEGF in the salivary glands. Time of death after BMT was displayed by means of the Kaplan-Meier method for the following parameters: age and gender of the patients, donor gender, acute GVHD, cGVHD staging at the labial salivary glands, primary disease, platelet and neutrophils counts on day of biopsy, stem cell, oral mucositis, parenteral nutrition, oral lichenoid lesions of GVHD, conditioning regimen and immunolocalization degree of VEGF in labial salivary glands. The data were initially analyzed by means of the log-rank test and then included in the Cox's proportional hazard model. RESULTS: No differences on the immunolocalization of VEGF in the labial salivary glands of BMT recipients and control group or between the different stages of glandular cGVHD were noted. Both univariate and multivariate analysis of the survival rate showed significance of 5% only for platelet count over 100 x 109/l on the day of biopsy and male donor gender. CONCLUSIONS: Platelet count over 100 x 109/l and male donor gender are positive predictive factors on the survival rate after BMT. In addition, the immunolocalization of VEGF in salivary glands is not altered in BMT recipients at day 100+ and is not influenced by the stage of cGVHD.

Adult↗

Sjögren's syndrome in inflammatory rheumatic diseases: analysis of the leukocyte protein calprotectin in plasma and saliva.

In a hospital population of 154 patients with a wide range of inflammatory rheumatic diseases, patients with sicca symptoms were subjected to objective ocular and oral tests to establish cases with Sjögren's syndrome (SS). The plasma level of the leukocyte protein calprotectin has been shown to be a good indicator of disease activity and inflammation in various rheumatic diseases. In the present study, calprotectin levels in plasma and whole saliva were analysed and evaluated as potential markers of SS and salivary gland disease activity. Plasma calprotectin levels did not differ significantly between patients with SS and patients with no sicca symptoms. However, salivary calprotectin levels correlated significantly with the plasma calprotectin levels and with several ocular variables, weakly with salivary flow and serum rheumatoid factor, but not with focal sialadenitis. In conclusion, this study shows that salivary calprotectin levels seem to be associated with several variables of SS glandular pathology, indicating the need for further and more comprehensive studies on calprotectin in various oral fluids and in lacrimal fluid in relation to SS glandular disease activity.

Blood↗

Salivary gland malignancies in children.

Malignant salivary gland neoplasms in children are rare. Such tumors usually occur in the parotid gland of older children. Sixteen cases of major salivary gland malignancy are reviewed, 14 occurring in the parotid gland and two in the submandibular gland. Adenoid cystic carcinoma was the most common malignancy encountered, occurring in five patients; four have died of disease. Low-grade mucoepidermoid carcinoma occurred in three patients and all remain alive and free of disease. An assorted variety of other cancers occurred in eight patients. One child died of reticulum cell sarcoma of the parotid gland, and two children have died of adenocarcinoma. The remaining five patients remain alive and free of disease. Salivary gland malignancies in children appear to have similar biological activity as those occurring in adults. Such tumors must be treated according to the same principles generally accepted for management of salivary gland malignancies in adults.

Adenocarcinoma↗

Diagnosis of sialodacryoadenitis virus infection of rats in a virulent enzootic outbreak.

In a natural outbreak of sialodacryoadenitis virus it was observed that the incidence of clinical signs in spontaneous-hypertensive rats was 100%, and that these signs were of a severity not observed before in other strains of rats. Rats free of the virus were introduced so that the progress of the disease could be studied under natural conditions of spontaneous spread from the enzootically-affected breeding colony. The pathogenesis of the infection in these Sprague-Dawley rats has been recorded over a period of 10 days after their introduction to the colony, and the results of extensive serological screening have shown that the antibody response of the spontaneous-hypertensive rats to the virus is lower than in other strains of rat.

Animals↗

Sialographic and ultrasonographic analyses of major salivary glands.

Seventy patients with major salivary gland diseases (60 parotis, 10 submandibular) were examined both with sialography and ultrasonography. The clinical and histopathological results were compared with radiological interpretations. Sialography was found to be 60% accurate for the diagnosis of salivary gland tumors and cysts and 63% for the diagnosis of inflammatory diseases. Ultrasonography diagnosed 95% of the tumors and 63% of inflammatory diseases accurately.

Adolescent↗