Sialadenitis

Sialadenitis(Sialoadenitis)
Micrograph showing chronic sialadenitis. H&E stain.

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List of terms related to Sialadenitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Sialadenitis (sialoadenitis) is inflammation of a salivary gland. It may be subdivided temporally into acute, chronic and recurrent forms.

Classification

Acute

Predisposing factors

• decreased flow (dehydration, post-operative, drugs)
• poor oral hygiene
• exacerbation of low grade chronic sialoadenitis

Clinical features

• Painful swelling
• Reddened skin
• Edema of the cheek, Periorbital region and neck
• low grade fever
• malaise
• raised ESR, CRP, leucocytosis
• purulent exudate from duct punctum

Chronic

Clinical Features

• unilateral
• mild pain / swelling
• common after meals
• duct orifice is reddened and flow decreases
• may or may not have visible/palpable stone.
• Parotid gland
  • Recurrent painful swellings
• Submandibular gland
  • Usually secondary to sialolithiasis or stricture

Causes

• Drug side effect:Hydrochlorothiazide, Pergolide

Treatment

In chronic recurrent sialadenitis or chronic sclerosing sialadenitis, acute attacks are managed with conservative therapies such as hydration, analgesics (mainly NSAIDs), sialogogues to stimulate salivary secretion, and regular, gentle gland massage. If infection is present, appropriate cultures should be obtained, followed by empirical antibiotic therapy initially, for example amoxicillin/clavulanate or clindamycin which cover oral flora.

If there are attacks more than approximately 3 times per year or severe attacks, surgical excision of the affected gland should be considered.