21 - Diagnosis and Management of Salivary Gland Disorders

Abstract

This chapter provides a comprehensive review of salivary gland disease and pathology. The diagnosis and management of salivary gland disorders requires an understanding of the embryology, anatomy, and physiology of the salivary glands and the appropriate use of available diagnostic modalities, including patient history and clinical examination, radiographic evaluation, sialography, and sialoendoscopy, sialochemistry, and fine-needle aspiration, or open biopsy, when indicated. Obstructive salivary gland disorders are diagnosed by history and clinical and radiographic examination, and are managed by removal of the obstruction (e.g., sialolith), or gland removal. Mucous retention or extravasation phenomena are diagnosed clinically and are treated by excision or marsupialization. Salivary gland infections may be acute or chronic and are treated with supportive care (e.g., hydration), and antimicrobial therapy. Necrotizing sialometaplasia is a self-limited disease of the minor salivary glands, and Sjogren syndrome is managed with symptomatic care for dry eyes and dry mouth. Traumatic salivary gland injuries may require ductal repair or gland removal. Salivary gland tumors may be benign or malignant and are treated with surgical excision and adjunctive measures (e.g., radiation therapy), when indicated.