Salivary Gland Ducts Research Articles

EXCISÃO DE MUCOCELE EM LÁBIO INFERIOR: RELATO DE CASO

Mucocele is the phenomenon of mucin leakage into soft tissues. The most common benign lesion of the oral cavity, of traumatic etiology, pseudocyst that appears after rupture of the duct of a minor salivary gland, with a predilection for the lower lip, floor of the mouth, belly of the tongue, followed by the buccal mucosa. It is worth mentioning that mucoceles can be self-limiting, that is, they rupture leaving shallow, painful ulcers and then heal on their own. However, there are mucoceles of a chronic nature, which require surgical excision and microscopic evaluation. In this sense, the present work aims to carry out a literature review as well as describe a clinical case report of mucocele in the lower lip, whose treatment of choice was surgical excision. In short, the chosen procedure is considered by many authors to be atraumatic, safe and effective.

Sialolithiasis of the Submandibular Gland- A Case Report

Sialolithiasis refers to the presence of calcified structures within the ducts of salivary glands and is the most common disorder affecting these glands. Approximately 80-95% of sialoliths occur in the submandibular salivary gland. The occurrence rate of sialoliths is about 12 per 1000 individuals, with men being affected approximately twice as often as women. Sialoliths can be diagnosed through clinical examination, conventional radiography, computed tomography, and ultrasonography. Typical clinical indicators of sialoliths include painless swelling, sometimes extensive, often accompanied by difficulty opening the mouth (trismus) during eating, and symptoms that vary from mild discomfort to severe pain. This case report illustrates the clinical, radiological signs, and surgical treatment of a salivary stone in the submandibular gland.

F-actin and heparan sulfate proteoglycan distribution in female mosquito salivary glands and ducts.

Directly involved in the "suck-and-spit" physiology, female mosquito salivary glands (SGs) primarily imbibe blood for egg development and release anticoagulants to keep blood flowing. Indirectly involved, mosquitoes can uptake arboviruses during blood feeding from a viremic host. This research examined the presence of the filamentous cytoplasmic contractile protein (F-actin) and heparan sulfate proteoglycan (HSPG), in the female mosquito SGs. Immunofluorescent antibody labeling of actin molecules or HSPG combined with anatomy suggests that F-actin forms a network in the SG lobe parenchymal cells attached to intralobar ducts by HSPG. In addition, F-actin twists around intralobar SG ducts in a beaded manner, altogether involved in the expulsion of SG secretions. This arrangement in female Aedes aegypti SGs, suggests that F-actin structures are integrally involved in transmitting infectious agents into hosts.

Understanding Mucocele of Tongue in Children: A Case Report

Introduction: Mucocele is cystic lesion that occur in oral cavity. Commonly it happens due to trauma or obstruction of minor salivary gland ducts. Certain mucoceles may heal spontaneously, while others might surgical intervention due to frequent recurrence. Mucoceles on the tongue are rare and typically occur on the underside, where the glands of Blandin and Nuhn are located. Appropriate diagnose and treatment must be chosen correctly. Case History: A 12-years old-girl presented of enlarged gum and recurrent swelling firstly noticed a month ago. Excision was done under local anesthesia using electrocautery. A clinical diagnose of mucocele was confirmed by histopathological examination. Discussion: Mucoceles on the tongue are uncommon and primarily occur on the ventral surface where the glands of Blandin and Nuhn are situated. Complete excision was done once the diagnosis was confirmed using electrocautery which have indicated that this method is faster, simpler, and causes minimal postoperative discomfort compared to conventional excision. To minimize recurrence, strategies such as removing surrounding glandular acini, excising or dissecting the lesion down to the muscle layer, and avoiding damage to adjacent glands and ducts are recommended. Conclusion: Mucoceles on the tongue are uncommon and primarily occur on the ventral. Since mucocele are asymptomatic, complete surgical excision of mucocele of tongue must followed by eliminate risk factors to prevent recurrency.

Duct ligation/de-ligation model: exploring mechanisms for salivary gland injury and regeneration.

Sialadenitis and sialadenitis-induced sialopathy are typically caused by obstruction of the salivary gland ducts. Atrophy of the salivary glands in experimental animals caused by duct ligation exhibits a histopathology similar to that of salivary gland sialadenitis. Therefore, a variety of duct ligation/de-ligation models have been commonly employed to study salivary gland injury and regeneration. Duct ligation is mainly characterised by apoptosis and activation of different signaling pathways in parenchymal cells, which eventually leads to gland atrophy and progressive dysfunction. By contrast, duct de-ligation can initiate the recovery of gland structure and function by regenerating the secretory tissue. This review summarizes the animal duct ligation/de-ligation models that have been used for the examination of pathological fundamentals in salivary disorders, in order to unravel the pathological changes and underlying mechanisms involved in salivary gland injury and regeneration. These experimental models have contributed to developing effective and curative strategies for gland dysfunction and providing plausible solutions for overcoming salivary disorders.

Trotter Procedure with Harmonic Scalpel : A Unique Approach to Mucoepidermoid Carcinoma of Tongue Base Revisited.

Mucoepidermoid carcinoma (MEC) is a malignant locally invasive tumour of salivary glands, presumed to arise from reserve cells of salivary gland ducts. It accounts approximately 35% of all malignancies of major and minor salivary glands [1]. MEC arising in minor salivary glands can be located in different areas such as palate, retromolar trigone, floor of mouth, buccal mucosa, lips and tongue. MEC of tongue base are not common but they constitute around 50% of malignant lesions of salivary glands in this region. It presents in fifth and sixth decades of life mostly [1]. We present a rare case of 29 year old woman with low grade mucoepidermoid carcinoma of base of tongue operated by the Trotter procedure with harmonic scalpel - median labio-mandibular glossotomy approach. It's an interesting approach first described by William Trotter in 1920s. It's used by head and neck surgeons for accessing tongue base lesions, pharyngeal wall and cervical spine.

Oral Mucocele in Pediatric Patient: A Case Report

Mucoceles can appear anywhere on the oral mucosa where there are minor salivary glands. Because the diagnosis is mostly clinical in character, it is important to appropriately do the anamnesis in order to look for any prior trauma. Extravasation and retention mucocele are the two main forms that can develop. Although retention mucoceles can appear anywhere, extravasation mucoceles typically occur on the lower lip. Histologically, mucoceles can be divided into extravasation types and retention types, with extravasation types being more prevalent. The extravasation mucocele, also known as a "mucous retention cyst," lacks an epithelial lining and a defined border. It is thought that trauma to a small salivary gland excretory duct causes an extravasation mucocele to occur. Saliva pools in the nearby submucosal tissue as a result of duct laceration, which causes edema. The obstruction of a minor salivary gland duct, frequently by a sialolith, periductal scarring, or tumor, results in the retention type mucocele. Saliva builds up and the duct enlarges due to the obstruction of salivary flow. A 9-year-old child arrived to Rumah Sakit Gigi dan Mulut Universitas Muhammadiyah Yogyakarta with his mother, complaining of a lump on his lower lip. Patient frequently bit his lips since the lump has been there for a few months. It did not hurt and occasionally grew in size. The lump bothered the patient. The dentist performed minor surgery to remove the mucocele. Minor surgery was performed with infiltration anesthesia around the mucocele and then used blade no. 15 for excision of the mucocele. For postoperative wounds, braided surgical sutured silk was used. Post-operative instructions were given, antibiotics and analgetic were prescribed. Patient was recalled after 1 week for the removal of sutures. No recurrence was seen after a follow up at 1 month and 3 months.International Journal of Human and Health Sciences Supplementary Issue 01: 2024 Page: S53

Unveiling the Mechanisms of Fluid Secretion in Parotid Gland Ducts: CFTR Dependency, Cellular Contributors, and Signaling Pathways

Compelling evidence indicates that salivary gland ducts mediate fluid secretion, yet the specific cell types responsible for this process remain unclear. Our study aimed to elucidate the fundamental mechanisms governing fluid secretion within ducts and to determine their significance within the context of parotid gland function.Consistent with previous research in exocrine gland ducts, fluid secretion in parotid gland ducts is enhanced when both calcium and cAMP signaling pathways are simultaneously stimulated. Furthermore, we found that duct fluid secretion depends on the activities of CFTR, NKCC1, and the cAMP-activated kinase PKA.To further investigate the cellular contributors to duct-mediated fluid secretion, we generated a mouse model lacking ionocytes in salivary gland ducts using a diphtheria toxin-based approach. Our findings showed that ionocytes play a key role in the process of duct fluid secretion, as their absence resulted in impaired fluid secretion.Overall, our results underscore the significance of ionocytes in facilitating duct fluid secretion, highlighting the essential interplay between calcium and cAMP signaling pathways to achieve optimal secretion. Moreover, our research identified specific basolateral and apical ion-transporting proteins involved in the fluid secretion process. The pharmacological activation of ionocytes may offer a viable alternative secretory pathway when the function of secretory acinar cells is compromised, as observed in pathological conditions that lead to xerostomia. Fondecyt 1211838. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sialolithiasis in Sublingual Glands Involving the Floor of the Mouth: A Case Report

Sialolithiasis is a benign condition involving the formation of stones within the ducts of the major salivary glands: parotid, submandibular, and sublingual glands. It is the most frequent cause of salivary gland swelling, with a reported incidence of 1 in 10000–1 in 30000. It can obstruct the salivary ducts, leading to inflammation, superimposed bacterial infection termed sialadenitis, or, in rare cases, abscess formation. And decreased salivary flow rate. Treatment options for sialolithiasis, including sialogogues, direct massage of distal stones out of the duct, and other procedures, including interventional sialography, sialoendoscopy, and surgical management. In this article, we report a 20-year-old female presented with a case of sublingual gland Sialolithiasis treated with simply milking of the duct.

Mucocele Treatment in Pediatric Patient at RSGM UMY

Background : Mucoceles is minor salivary gland lession. The extravasation mucocele, commonly referred to as a "mucous retention cyst," does not have an epithelial lining or a well-defined boundary. An extravasation mucocele is believed to be caused by damage to a tiny salivary gland excretory duct. Saliva accumulates in the adjacent submucosal tissue due to a tear in the duct, leading to swelling. Retention type mucocele occurs when a small salivary gland duct is blocked, often by a sialolith, periductal scarring, or tumor. Salivary flow blockage leads to the accumulation of saliva and the enlargement of the duct. Objective : To provide treatment for mucocele in a pediatric patient at RSGM UMY Case Report : A 9-year-old patient came to RSGM UMY accompanied by his mother, complain he has swelling on lower lip. He often bite the lower lip for a long time. It is painless and sometimes increases in size. His experiencing discomfort due to the bump. Method : The mucocele was excised using infiltration anesthetic and a blade no. 15. Surgical sutured silk braided was utilized for postoperative wound closure. The patient was provided with post-operative instructions and prescribed antibiotics and analgesics. The patient was scheduled for a follow-up appointment after one week to have the sutures removed. Result : No complaints after control 1 month and 3 months after treatment Conclusion : Surgical removal remains the optimal choice for treating mucoceles due to its simplicity and cost-effectiveness compared to laser ablation, cryosurgery, and electrocautery

Triamcinolone Acetonide Injection and Topical as an Alternative Method for Mucocel Therapy

Introduction: Mucocele is a swelling caused by the collection of saliva from the ducts of minor salivary glands that are cut off or blocked. This is a salivary gland cyst that contains mucus and generally founded in the oral cavity. Surgery is the most popular therapy in the treatment of mucocele. There are various alternative therapeutic modalities that can be used including laser ablation, cryosurgery, sclerotherapy, micromarsupialization, laser surgery, injection of sclerosis agents, and corticosteroid injection. Case and management: This paper describes the treatment of mucoceles using triamcinolone acetonide that is quite often used in the oral cavity. The therapy carried out is intradermal injection of 0.2 ml of triamcinolone acetonide IA/ID (10 mg/ml) and topical application of triamcinolone acetonide ointment in orabase 0.1% 6x/day. One week later it was seen that the mucocele lesion had almost disappeared. Discussion: Corticosteroids act as potent anti-inflammatory agents and also act like sclerosing agents causing shrinkage of the dilated salivary ducts. Conclusion: Triamcinolone acetonide can be an alternative therapy besides surgery in the management of mucocele cases. The application can be done by intradermal injection and topical ointment. No side effects were found at the end of treatment.

A mathematical model of ENaC and Slc26a6 regulation by CFTR in salivary gland ducts.

Cystic fibrosis (CF) is a genetic disease caused by the mutations of cystic fibrosis transmembrane conductance regulator (CFTR), the cystic fibrosis transmembrane conductance regulator gene. Cftr is a critical ion channel expressed in the apical membrane of mouse salivary gland striated duct cells. Although Cftr is primarily a Cl- channel, its knockout leads to higher salivary Cl- and Na+ concentrations and lower pH. Mouse experiments show that the activation of Cftr upregulates epithelial Na+ channel (ENaC) protein expression level and Slc26a6 (a 1Cl-:2[Formula: see text] exchanger of the solute carrier family) activity. Experimentally, it is difficult to predict how much the coregulation effects of CFTR contribute to the abnormal Na+, Cl-, and [Formula: see text] concentrations and pH in CF saliva. To address this question, we construct a wild-type mouse salivary gland model and simulate CFTR knockout by altering the expression levels of CFTR, ENaC, and Slc26a6. By reproducing the in vivo and ex vivo final saliva measurements from wild-type and CFTR knockout animals, we obtain computational evidence that ENaC and Slc26a6 activities are downregulated in CFTR knockout in salivary glands.NEW & NOTEWORTHY This paper describes a salivary gland mathematical model simulating the ion exchange between saliva and the salivary gland duct epithelium. The novelty lies in the implementation of CFTR regulating ENaC and Slc26a6 in a CFTR knockout gland. By reproducing the experimental saliva measurements in wild-type and CFTR knockout glands, the model shows that CFTR regulates ENaC and Slc26a6 anion exchanger in salivary glands. The method could be used to understand the various cystic fibrosis phenotypes.

Conventional Surgical Excision of Lower Lip Mucocele in Children

Introduction: Mucoceles, as a mucus escape reaction or mucus extravasation phenomenon, are prevalent benign abnormality affecting the salivary glands. Most commonly occur in the lower lip in children and young adults. It emerges in response to trauma and obstruction of salivary gland ducts. Mucoceles are typically painless but can be troublesome for individuals while eating and speaking. Case report: An 8-year-old boy reported a lower lip mucocele due to their habit of lip biting. The lesion has been treated with a conventional surgical excision under local anesthesia and followed up after one week. The results showed that the mucocele lesion healed, no remnant was seen, and there was no complaint from the patient. Discussion: Oral mucoceles in the lower lip occur in children due to mucosa trauma or lip biting. For the patient reported here, conventional surgical excision using a scalpel was the treatment option due to the small size and superficial form of the lesion, so excisions can be done more easily with minimal postoperative wounds. Conclusion: Conventional surgical excision guarantees the removal of a whole small superficial mucocele lesion. Moreover, identifying the underlying cause of oral mucocele is crucial for patient education, enabling them to comprehend their condition and take measures to prevent its recurrence.

Immunohistochemical Expression of Estrogen Receptors in Pleomorphic Adenoma and Normal Salivary Gland Tissue

Background: The expression of estrogen receptors (ERs) in salivary gland tissue has been observed in some studies. Considering the histological similarity of salivary glands and breast tissue, as well as the prominent role of this receptor in the pathogenesis, treatment, and prognosis of breast tumors, this study aimed to compare the immunohistochemical expression of ERs in pleomorphic adenoma (PA) and normal salivary gland tissue and assess its possible role in salivary gland tumors. Methods: In this descriptive-analytical study, 26 samples of PA (16 females, and 10 males) and 12 samples of normal salivary gland tissue were selected. Immunohistochemical staining was performed by the standard EnVision method for ERs. The results were evaluated semi-quantitively as the percentage of the nuclear and cytoplasmic staining were analyzed independently by Mann-Whitney, Kruskal-Wallis, and Fisher’s exact tests. Results: All PA samples showed negative nuclear staining for ERs. ER expression was observed in the cytoplasm of the ducts in 27% of tumors and 59% of normal salivary gland tissue samples, but the difference was not statistically significant. In addition, no association was found between ER expression and independent variables, such as age, sex, the type of stroma, or the degree of cellularity in PA, and the location of the specimen. Conclusion: It seems that the expression of ERs does not play an effective role in the development and progression of PA. However, its occurrence in the normal salivary gland ducts is considerable, and further studies in this field seem to be necessary.

Management of mucoid cysts of the oral cavity: Cases series and review

IntroductionA mucoid cyst is a benign lesion in the oral mucosa resulting from the rupture of a salivary gland duct and the subsequent discharge of mucin into the soft tissues. Mucoceles are more common in children and young adults, and the most common site is the lower inner lips. Cases series presentationWe describe 3 clinical cases managed in service between 2022 and 2023. Clinical cases are presented in order to detail their clinical history, paraclinical and treatment. Discussion and conclusionIn general, mucoceles tend to resolve spontaneously, but can sometimes interfere with swallowing or speech. Therefore, in such cases, these lesions must be promptly diagnosed and treated. There are various methods of managing these lesions, each with its own advantages and disadvantages.Surgical technique is preferable when the lesion is persistent, recurrent or symptomatic, and remains the most effective strategy, despite the existence of other, more modern techniques that are better tolerated by patients. But in all cases, follow-up is very important, especially when the mucocele is located in a particular area, such as the ventral side of the tongue, or in a younger population.

Caracterización de litiasis en glándulas salivales menores: reporte de casos y revisión de un fenómeno poco frecuente

Sialolithiasis is a relatively common condition, affecting the major salivary gland ducts with a higher incidence. The finding of sialolithsin minor salivary glands is extremely rare. Some of the reasons that would indicate the limited scientific evidence surrounding the diagnosis of minor salivary gland sialolithiasis could be associated with an underdiagnosis of the pathology,and the absence of histopathological diagnosis after surgical excision. Objective: two cases are presented, in adult patients, with clinical and histopathological diagnosis of sialolithiasis in minor salivary glands, who attended the Outpatient Clinic of the Chair of Stomatology A, of the Faculty of Dentistry, of the National University of Córdoba, in the period 2021-2022. Additionally, a narrative review of some of the possible etiological aspects of this phenomenon is provided. It is important to report these cases togenerate greater scientific evidence about this entity and, in this way, achieve a better understanding of it, expand the range of differential diagnoses and therapeutic options for this pathology

FGFR2 is essential for salivary gland duct homeostasis and MAPK-dependent seromucous acinar cell differentiation

Exocrine acinar cells in salivary glands (SG) are critical for oral health and loss of functional acinar cells is a major clinical challenge. Fibroblast growth factor receptors (FGFR) are essential for early development of multiple organs, including SG. However, the role of FGFR signaling in specific populations later in development and during acinar differentiation are unknown. Here, we use scRNAseq and conditional deletion of murine FGFRs in vivo to identify essential roles for FGFRs in craniofacial, early SG development and progenitor function during duct homeostasis. Importantly, we also discover that FGFR2 via MAPK signaling is critical for seromucous acinar differentiation and secretory gene expression, while FGFR1 is dispensable. We show that FGF7, expressed by myoepithelial cells (MEC), activates the FGFR2-dependent seromucous transcriptional program. Here, we propose a model where MEC-derived FGF7 drives seromucous acinar differentiation, providing a rationale for targeting FGFR2 signaling in regenerative therapies to restore acinar function.

Diagnostic challenges of superficial mucoceles: An update.

A superficial mucocele is a unique variant of a mucocele of the oral cavity that was described by Eveson for the first time in 1988. It occurs due to subepithelial extravasation of sialomucin at the epithelial-connective tissue interface and is related to damage of the minor salivary gland ducts. Clinically, they appear as small, asymptomatic, clear, tense vesicles with a predilection for the soft palate, retromolar pads, and posterior buccal mucosa. They are reported to occur more frequently in women than in men. Before Eveson endeavoured to describe these rather peculiar lesions, they were often misdiagnosed as vesiculobullous lesions such as bullous lichen planus, mucous membrane pemphigoid, and the like. It is incumbent on the present-day pathologist to be cognizant of the presence of these entities as it could present a formidable diagnostic challenge otherwise. This review gives an updated account on the etiology, prevalence, clinical features, differential diagnosis, and management of superficial mucoceles.

MANAGEMENT OF BILATERAL RANULA: A CASE REPORT

Ranula is a retention pseudocyst caused by an obstruction or trauma in the duct of the sublingual salivary gland which causes mucus extravasation. The ranula that extends through the mylohyoid muscle into the submandibular space is called plunging ranula. The prevalence of ranula is approximately 0.2 cases per 1000 individuals, accounting for 6% of intraoral salivary gland cyst, meanwhile plunging ranulas are still unknown. Simple ranulas generally occurs in children and young adults, meanwhile plunging ranulas occurs in patients aged 20-29. Ranula conditions are generally unilateral, meanwhile bilateral ranula is a rare case. In this case, we presented a plunging ranula case with bilateral condition in a patient aged 10 years old. This paper aimed at presenting a rare case to highlight the etiology, diagnosis, treatment, and prognosis of this condition.

An immunohistochemical study of the vasculature and stem cells and carbonic anhydrase IV in the ducts of irradiated and normal human submandibular salivary glands

ABSTRACT Therapeutic irradiation for cancers of the head and neck causes serious and irreversible damage to the salivary glands; the resulting adverse effects on salivary quality and quantity produce detrimental effects on teeth and oral mucosa. The salivary effects have been related mostly to loss of serous acini; damage to the ducts is relatively minor. Other radiation effects include fibrosis, adiposis and vascular damage. Stem cells in the salivary gland ducts have the potential to generate acinar cells in vitro and in vivo. I investigated the ducts and vasculature in irradiated and normal human submandibular glands using immunohistochemical localization of biomarkers of stem cells, duct function and blood vessels. Stem cell markers CK5 and Sca-1 labeled the cytoplasm of the basal and intercalated duct cells and all duct cells, respectively, in both normal and irradiated glands. CA IV, which participates in regulating salivary electrolytes and acid-base balance, labeled the cytoplasm of all ducts. CD34 labeling demonstrated more extensive vasculature in the irradiated glands than in the normal glands. My findings suggest that duct stem cells and at least one duct function persisted, and the vasculature was greater, despite moderate fibrosis, in the irradiated gland.