Parotid sialometry: A standard technique in the diagnosis of parotid sialadenosis

Abstract

Abstract Sialadenosis is a clinical condition characterized by bilateral, painless, diffuse and recurrent parotid gland swelling. Histologically, the only feature of note is acinar cell hypertrophy, with no apparent change in the duct structure or cellular infiltrate. The functional changes in the parotid parenchyma in this condition are ill understood. The association between malnutrition and parotid gland swelling was first reported in Egypt. The pathogenesis of the condition remains unclear. The aim of this study is to explain the development of parotomegaly by analysing the parotid secretory pattern in parotomegaly patients Patients with malnutrition were studied at Ain Shams University Hospitals. 47 patients, 19 male patients and 28 female patients, were studied, of these eight patients (three male patients and five female patients) suffered parotomegaly. Thirty-one patients with morbid obesity were recruited. 23 patients were female and eight were male. Six patients in this group had parotomegaly. Results were compared with those of 30 healthy volunteers recruited from medical and nursing staff, medical students and patients attending the ENT clinic for minor procedures. Parotid saliva was collected by the standard technique The results of salivary analysis in 47 patients suggested a pattern of inhibitory proteodyschylia, with increased salivary flow rate and reduced total protein level and amylase activity compared with 30 healthy volunteers. This inhibitory proteodyschylia pattern is identical to the secretory pattern induced experimentally by blocking B-adrenergic receptors in the parotid A possible explanation for the development of parotomegaly in malnutrition is a degenerative neuropathy affecting the B-adrenergic innervation of the parotid that cause acinar cell congestion by zymogen granules, which is manifested clinically as parotomegaly.