The medical history represents an important component in the diagnosis of sialadenitis, in addition to the findings. Family history What is the general health of your family? Infectious diseases? Social history What is your profession? Are you at risk of infection in your profession? Current medical history / systemic history (somatic and psychological complaints). What … Salivary Gland Inflammation (Sialadenitis): Medical History
Blood, blood-forming organs-immune system (D50-D90). Febris uveoparotidea (Heerfordt syndrome) – chronic inflammation of the parotid (parotid gland) and lacrimal glands. It may be associated with involvement of the iris and ciliary body of the eye (iridocyclitis), cranial nerves, female breast, or gonads; occurs especially in association with sarcoidosis (synonyms: Boeck’s disease; Schaumann-Besnier’s disease; systemic disease … Salivary Gland Inflammation (Sialadenitis): Or something else? Differential Diagnosis
The most important diseases or complications that can be caused by sialadenitis (salivary gland inflammation) are: Eyes and eye appendages (H00-H59). Inflammation of the eyes [parotitis epidemica] Dacryoadenitis (inflammation of the lacrimal glands) [parotitis epidemica] Keratoconjunctivitis sicca (“dry eyes”) [Sjögren’s or Sicca syndrome] Certain conditions originating in the perinatal period (P00-P96). Sialadenal fetopathy (disease of … Salivary Gland Inflammation (Sialadenitis): Complications
Classification of sialadenitis according to cause: Bacterial cause Due to ascending infection by hematogenous (“caused by the blood”) dissemination Probably in marantic overall situation (protein deficiency caused). Probably in otherwise stressed overall situation (eg, after surgical procedures). By lymphogenic scattering Secondary by obstruction of the excretory duct (outflow obstruction by concretion or stone: sialolithiasis; by … Salivary Gland Inflammation (Sialadenitis): Classification
A comprehensive clinical examination is the basis for selecting further diagnostic and therapeutic steps. Extraoral examination Inspection Facial asymmetries [Lateral difference visible with swelling of parotid glandulae (parotid glands) and sublingual glandulae (sublingual glands) from extraoral (“outside the oral cavity”)] [bilateral swelling visible] Facial motor function Lateral comparison of facial nerve function [in changes of … Salivary Gland Inflammation (Sialadenitis): Examination
2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Parotitis epidemica: see under the disease of the same name. Cytomegaly: see under the disease of the same name. HIV infection: see under the … Salivary Gland Inflammation (Sialadenitis): Test and Diagnosis
Therapeutic targets In case of bacterial infection: cure. Pain relief Relief of xerostomia (dry mouth) Therapy recommendations Symptomatic therapy Analgesia (analgesics/painkillers). Nonacid analgesics: Paracetamol Antipyretics (antipyretic agents), if necessary. If necessary, also antiphlogistics (drugs that inhibit inflammatory processes): acetylsalicylic acid (ASS), diclofenac, ibuprofen, indometacin. Antibiosis – for bacterial infection. Indications: Acute bacterial sialadenitis Postoperative parotitis … Salivary Gland Inflammation (Sialadenitis): Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic workup X-ray Panoramic overview radiograph Rarely indicated as a conventional blank image. In sialolithiasis (salivary stone): shadowing – concretions are detectable only with sufficient calcium content and a minimum size … Salivary Gland Inflammation (Sialadenitis): Diagnostic Tests
Oral and maxillofacial surgery. Acute postoperative parotitis: Abscess incision (incision into an encapsulated pus cavity) and capsule splitting if necessary for purulent parotitis (parotid gland inflammation), otherwise irreversible damage to the gland parenchyma due to pressure within the parotid capsule If necessary, surgical opening of the parotid lodge and subsequent drainage. Surgical removal of an … Salivary Gland Inflammation (Sialadenitis): Surgical Therapy
To prevent sialadenitis (salivary gland inflammation), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Decreased fluid intake Saliva reduction caused by exsiccosis (dehydration) and associated bacterial infection; in overall marantic situation (protein deficiency situation), the parotid gland (parotid gland) is typically affected – marantic parotitis, marantic sialadenitis Disturbed electrolyte balance … Salivary Gland Inflammation (Sialadenitis): Prevention
The following symptoms and complaints may indicate sialadenitis (salivary gland inflammation): Viral sialadenitis Parotitis epidemica (mumps). Mumps affects both parotids (parotid glands) in the form of glandular swelling in about two-thirds of all cases. The maximum swelling is reached between the second and third day. After one to two weeks, the swelling gradually subsides. Low-grade … Salivary Gland Inflammation (Sialadenitis): Symptoms, Complaints, Signs
Pathogenesis (development of disease) Bacterial sialadenitis. Acute bacterial sialadenitis is usually favored by the presence of hyposialia (decreased salivary flow) and triggered by hemolytic streptococci (group A) and staphylococci (S. aureus). In ascending inflammatory mechanism, sialangitis (inflammation of the ductal system) is followed by invasion of the glandular parenchyma and consecutive hyposialia. Chronic sialadenitis Obstructive … Salivary Gland Inflammation (Sialadenitis): Causes
